Basic Information
| Provider Information | |||||||||
| NPI: | 1457412132 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHIGAN REHABILITATION SPECIALISTS OF HARTLAND LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10860 HIGHLAND RD | ||||||||
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| City: | HARTLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483532629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106321000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10860 HIGHLAND RD | ||||||||
| Address2: | |||||||||
| City: | HARTLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483532629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106321000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 08/08/2012 | ||||||||
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| AuthorizedOfficialLastName: | ROOKS | ||||||||
| AuthorizedOfficialFirstName: | FRANKLIN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 8102316904 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.