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General NPI Number Information
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NPI Number | 1528895364
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Entity Type | Organization
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Legal Business Name | KULSUM PELVIC REHAB SERVICES
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 4405 S BALDWIN RD STE E
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City | LAKE ORION
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State | MI
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Zip | 48359-2164
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Country | US
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Telephone | 248-972-5088
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Fax | 888-614-2006
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Provider Business Mailing Address
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Address Line | 2661 AUBREY DR
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City | LAKE ORION
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State | MI
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Zip | 48360-2702
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Country | US
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Telephone | 248-212-4203
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. SAMEENA KULSUM SYED
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Credential | PT
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Telephone | 248-212-4203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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