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General NPI Number Information
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NPI Number | 1982770673
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Entity Type | Organization
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Legal Business Name | NORTHVILLE PHYSICAL REHABILITATION, P.C.
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 215 E MAIN ST SUITE B
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City | NORTHVILLE
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State | MI
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Zip | 48167-1681
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Country | US
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Telephone | 248-349-9339
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Fax | 248-349-9342
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Provider Business Mailing Address
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Address Line | 215 E MAIN ST SUITE B
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City | NORTHVILLE
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State | MI
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Zip | 48167-1681
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Country | US
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Telephone | 248-349-9339
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Fax | 248-349-9342
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Authorized Official
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Title or Position | DIRECTOR
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Name | DENNIS E. ENGERER
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Credential |
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Telephone | 248-349-9339
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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 | 5501002317
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License Number State | MI
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