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General NPI Number Information
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NPI Number | 1962920587
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Entity Type | Organization
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Legal Business Name | MAHA PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 09/04/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 30801 SCHOENHERR RD
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City | WARREN
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State | MI
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Zip | 48088
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Country | US
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Telephone | 313-784-0999
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Fax | 313-784-0999
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Provider Business Mailing Address
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Address Line | 30801 SCHOENHERR RD
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City | WARREN
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State | MI
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Zip | 48088-6857
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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 | OWNER
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Name | OMAR ALMEMAR
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Credential |
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Telephone | 313-784-0999
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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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