Organization Name: | MACOMB OAKLAND REGIONAL CENTER INC. |
NPI Number: | 1871696047 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GERALD PROVENCAL (CEO) |
Mailing Address: | 16200 19 Mile Rd Clinton Township |
State: | MI US |
Postal Code: | 480381103 |
Phone Number: | 5862638700 |
Fax Number: | 5864127889 |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 09/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501011192 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |