Organization Name: | ADVANCED NEURO REHAB SERVICES |
NPI Number: | 1710023916 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA JOHNSON (OFFICE MANAGER) |
Mailing Address: | 26635 Woodward Avenue Suite 101 Huntington Woods |
State: | MI US |
Postal Code: | 48070 |
Phone Number: | 2485486400 |
Fax Number: | 2485488885 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 06/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251N0400X |
License Number: | HP050806-4301050806 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Neurology |
Taxonomy Definition: |