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General NPI Number Information
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NPI Number | 1942000682
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Entity Type | Organization
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Legal Business Name | MID STATE VOCATIONAL REHABILITATION SERVICES LLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 36051 FIVE MILE RD STE B
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City | LIVONIA
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State | MI
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Zip | 48154-1931
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Country | US
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Telephone | 248-270-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 527 WORCHESTER ST
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City | WESTLAND
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State | MI
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Zip | 48186-3826
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Country | US
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Telephone | 734-837-0734
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEITH MCARTHUR II
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Credential |
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Telephone | 248-270-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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