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General NPI Number Information
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NPI Number | 1780714949
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Entity Type | Organization
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Legal Business Name | ALLWELL PHYSICAL THERAPY AND REHABILITATION INC.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5747 N BERRY ST
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City | WESTLAND
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State | MI
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Zip | 48185-8101
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Country | US
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Telephone | 734-674-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 5747 N BERRY ST
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City | WESTLAND
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State | MI
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Zip | 48185-8101
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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 | PRESIDENT
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Name | AHINZE OSUAMADI
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Credential |
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Telephone | 734-674-1168
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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 | 5501005748
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License Number State | MI
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