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General NPI Number Information
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NPI Number | 1649011743
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Entity Type | Organization
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Legal Business Name | REHAB LAB LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 884 S ROCHESTER RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2740
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Country | US
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Telephone | 248-781-4374
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Fax |
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Provider Business Mailing Address
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Address Line | 53772 REGENCY HILLS CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-2047
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Country | US
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Telephone | 248-939-0052
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANNY AZZOW
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Credential |
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Telephone | 248-939-0052
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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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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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