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General NPI Number Information
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NPI Number | 1881926541
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Entity Type | Organization
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Legal Business Name | REGAL PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 9427 CONANT ST SUITE C
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3689
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Country | US
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Telephone | 313-873-6220
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Fax | 248-941-0562
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Provider Business Mailing Address
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Address Line | 9427 CONANT ST SUITE C
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3689
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Country | US
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Telephone | 313-873-6220
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Fax | 248-941-0562
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPHINE REINOSO
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Credential |
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Telephone | 313-873-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | JR004272
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License Number State | MI
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