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General NPI Number Information
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NPI Number | 1669479564
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Entity Type | Organization
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Legal Business Name | TOTAL CARE PHYSICAL THERAPY & REHABILITATION, INC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 17950 WOODWARD AVE 2ND FLOOR
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City | DETROIT
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State | MI
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Zip | 48203-2260
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Country | US
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Telephone | 313-865-5200
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Fax | 313-865-5300
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Provider Business Mailing Address
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Address Line | 17950 WOODWARD AVE 2ND FLOOR
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City | DETROIT
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State | MI
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Zip | 48203-2260
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Country | US
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Telephone | 313-865-5200
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Fax | 313-865-5300
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR, OT
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Name | MR. VIJAY MISHRA
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Credential | O.T.
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Telephone | 586-872-5133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | MI
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