=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538954292
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHIGAN REHAB CONSULTANT PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2025
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50714 NESTING RIDGE DR
-----------------------------------------------------
City | MACOMB
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48044-1384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-224-3529
-----------------------------------------------------
Fax | 312-392-5195
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50714 NESTING RIDGE DR
-----------------------------------------------------
City | MACOMB
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48044-1384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-224-3529
-----------------------------------------------------
Fax | 312-392-5195
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. JULIET GAISEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 248-224-3529
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------