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General NPI Number Information
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NPI Number | 1700154481
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Entity Type | Organization
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Legal Business Name | SUBLIME PHYSICAL THERAPY & REHAB SERVICES
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 13244 W WARREN AVE SUITE 3
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City | DEARBORN
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State | MI
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Zip | 48126-1415
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Country | US
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Telephone | 313-581-3200
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Fax | 313-581-9085
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Provider Business Mailing Address
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Address Line | 4937 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3251
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Country | US
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Telephone | 313-945-9366
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Fax | 313-945-0070
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYED IRFAN HAIDER JILANI
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Credential | D.P.T.
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Telephone | 313-581-3200
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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 | 5501006285
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License Number State | MI
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