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General NPI Number Information
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NPI Number | 1902875941
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Entity Type | Organization
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Legal Business Name | MARINA REHABILITATION AND HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 1050 W UNIVERSITY DR SUITE 3
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City | ROCHESTER
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State | MI
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Zip | 48307-1877
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Country | US
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Telephone | 248-650-1984
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Fax | 248-650-1994
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Provider Business Mailing Address
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Address Line | 962 DOWLING RD
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-2523
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Country | US
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Telephone | 248-650-1984
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Fax | 248-650-1994
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Authorized Official
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Title or Position | PH.D P.T.
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Name | SAMIR W HANNA
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Credential |
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Telephone | 248-650-1984
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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 | 5501005736
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License Number State | MI
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