MEDICARE: HORIZON REHAB SPECIALISTS

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
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1689910671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON REHAB SPECIALISTS

Provider Business Mailing Address
First Line	:	22150 GREENFIELD RD STE 101
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-2535
Country	:	US
Telephone Number	:	248-967-2273
Fax Number	:	248-967-2266

Provider Business Practice Location Address
First Line	:	2055 FRANKLIN RD
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0327
Country	:	US
Telephone Number	:	248-967-2273
Fax Number	:	248-967-2266

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. GRZEGORZ ZAWISLAK
Credential	:
Telephone Number	:	248-967-2266

Provider Enumeration Date	:	12/19/2012
Last Update Date	:	12/19/2012

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