| NPI | 1225255672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE A CARVELL Physical Therapist 313-881-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 5501001604) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |