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NPI Code Detail

MEDICARE: PRIME REHAB SERVICES, LLC

MEDICARE: PRIME REHAB SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1407277320
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME REHAB SERVICES, LLC
Provider Business Mailing Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number : 313-436-4760
Fax Number :
Authorized Official
Title or Position : ADMIN
Name : MR. JOSEPH RUEFIEL
Credential :
Telephone Number : 313-436-4760
Provider Enumeration Date : 12/18/2013
Last Update Date : 12/18/2013

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Directions to “PRIME REHAB SERVICES, LLC ” Practice Location

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