| NPI | 1629582432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMAR GHOSN Manager 313-903-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: MI F2654C) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |