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Revive Dearborn PLLC

Physical Medicine & Rehabilitation in Dearborn, MI. Organization (NPI-2).

NPI number1447922026
StatusActive
Last updated in NPPESOct 1, 2021

Details

NPI
1447922026
Entity type
Organization (NPI-2)
Legal business name
Revive Dearborn PLLC
Organization subpart
No
Enumeration date
Oct 1, 2021
Certification date
Oct 1, 2021
Last updated
Oct 1, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes

Practice location

5225 Auto Club Dr Ste 101
Dearborn, MI 48126-2620

Phone 248-819-1703

Mailing address

5225 Auto Club Dr Ste 101
Dearborn, MI 48126-2620

Phone 248-819-7103

Authorized official

Yousef Almadrahi
Office Manager
2488286924

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