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General NPI Number Information
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NPI Number | 1619179884
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Entity Type | Organization
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Legal Business Name | PROCARE PHYSICAL THERAPY & REHABILITATION CENTRE
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 38004 FRINGE DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-3053
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Country | US
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Telephone | 248-353-3260
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Fax | 248-353-3275
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Provider Business Mailing Address
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Address Line | 3820 17 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-6831
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Country | US
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Telephone | 248-353-3260
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Fax | 888-267-1867
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIVEK SHIRISHKAR
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Credential | RPT
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Telephone | 248-353-3260
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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 | 5501006078
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License Number State | MI
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