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General NPI Number Information
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NPI Number | 1609303957
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Entity Type | Organization
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Legal Business Name | ADVANCE THERAPY & REHAB INC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 24350 JOY RD STE 2
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City | REDFORD
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State | MI
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Zip | 48239-1265
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Country | US
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Telephone | 313-948-3050
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Fax | 313-948-3080
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Provider Business Mailing Address
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Address Line | PO BOX 510655
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City | LIVONIA
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State | MI
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Zip | 48151-6655
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Country | US
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Telephone | 313-948-3050
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Fax | 313-948-3080
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Authorized Official
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Title or Position | OWNER
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Name | ATEF HAMAD
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Credential |
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Telephone | 313-525-1113
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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 | 5501006662
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License Number State | MI
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