| NPI | 1275802647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANISHA BREWER Adminstrator 313-627-1422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261Q00000X Clinic/Center | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |