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General NPI Number Information
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NPI Number | 1629341706
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Entity Type | Organization
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Legal Business Name | MAXIMUM REHAB PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 345 INKESTER RD
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City | INKESTER
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State | MI
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Zip | 48141
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Country | US
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Telephone | 248-790-5004
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Fax | 586-806-2584
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Provider Business Mailing Address
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Address Line | 345 INKESTER RD
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City | INKESTER
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State | MI
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Zip | 48141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RPT,DPT
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Name | JOSEPH LABIB
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Credential | DPT
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Telephone | 248-790-5004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5501011866
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License Number State | MI
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