Provider Demographics
NPI:1053306043
Name:UNITY REHABILITATION, P.C.
Entity Type:Organization
Organization Name:UNITY REHABILITATION, P.C.
Other - Org Name:HEALTHSTYLES PHYSICAL REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HERZOG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-486-1110
Mailing Address - Street 1:301 S LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1407
Mailing Address - Country:US
Mailing Address - Phone:248-486-1110
Mailing Address - Fax:248-486-3318
Practice Address - Street 1:301 S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1407
Practice Address - Country:US
Practice Address - Phone:248-486-1110
Practice Address - Fax:248-486-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30394OtherBCBS OF MI
MI404681298Medicaid
MI236614Medicare ID - Type Unspecified