Provider Demographics
NPI:1255476875
Name:HEALTHLINK PHYSICAL THERAPY & REHABILITATION SERVICES, INC.
Entity Type:Organization
Organization Name:HEALTHLINK PHYSICAL THERAPY & REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:586-983-3980
Mailing Address - Street 1:3058 METRO PARKWAY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:586-983-3980
Mailing Address - Fax:586-983-5173
Practice Address - Street 1:3058 METRO PARKWAY
Practice Address - Street 2:SUITE 207
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-983-3980
Practice Address - Fax:586-983-5173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISM005874208100000X
MICV006242208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N33900Medicare PIN