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General NPI Number Information
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NPI Number | 1689507758
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Entity Type | Organization
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Legal Business Name | TRI COUNTY REHAB AND PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 26190 OUTER DR STE B
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2084
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Country | US
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Telephone | 313-228-5302
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Fax | 313-228-5304
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Provider Business Mailing Address
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Address Line | 26190 OUTER DR STE B
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2084
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Country | US
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Telephone | 313-228-5302
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Fax | 313-228-5304
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHTESHAM A TAHIR
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Credential |
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Telephone | 734-512-6724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational 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 | 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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