| NPI | 1255867222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUJIT JOHN Admin 248-233-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |