| NPI | 1265236202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA A MAFIAH Managing Employee 313-580-1774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-09-09 |