| Organization Name: | ACTIVE PHYSICAL THERAPY AND REHAB SERVICES INC. |
| NPI Number: | 1053364679 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHAMUNDEESWARI MUTHUVINAYAGAM (OWNER/ADMINISTRATOR) |
| Mailing Address: | 718 Huron Ave Port Huron |
| State: | MI US |
| Postal Code: | 480603704 |
| Phone Number: | 8109668500 |
| Fax Number: | 8109668600 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 03/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | N/A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |