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General NPI Number Information
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NPI Number | 1962657742
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Entity Type | Organization
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Legal Business Name | CORE REHABILITATION SERVICES LLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 07/03/2021
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Provider Practice Location Address
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Address Line | 26000 HOOVER RD STE 100-101
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City | WARREN
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State | MI
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Zip | 48089-1167
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Country | US
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Telephone | 586-576-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 20507 EDMUNTON ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-3753
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Country | US
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Telephone | 313-478-1182
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS ANEMAECORE A BRODITH
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Credential | P.T.
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Telephone | 313-478-1182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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