| Organization Name: | MICHIGAN SPINE & ORTHOPEDIC REHAB INC |
| NPI Number: | 1003817909 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARBARA J JOHNSON (PRESIDENT) |
| Mailing Address: | 4918 W Clark Rd Ste 102 Ypsilanti |
| State: | MI US |
| Postal Code: | 481971142 |
| Phone Number: | 7345729800 |
| Fax Number: | 7345720762 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 05/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 5501003609 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |