Organization · NPI-2

12 Mile Rehab LLC

Physical Therapist · Southfield, MI

NPI number1538400528
StatusActive
Last updated in NPPESMar 15, 2013

Details

NPI
1538400528
Entity type
Organization (NPI-2)
Legal business name
12 Mile Rehab LLC
Organization subpart
No
Enumeration date
Mar 15, 2013
Last updated
Mar 15, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist–MIYes

Practice location

15600 W 12 Mile Rd
Suite A
Southfield, MI 48076-3068

Phone 248-968-2300

Mailing address

15600 W 12 Mile Rd
Suite A
Southfield, MI 48076-3068

Authorized official

Muhammad S. Awaisi
Owner
2489682300

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