Provider Demographics
NPI:1295364289
Name:MAX REHABILITATION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:MAX REHABILITATION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:KAMAL
Authorized Official - Last Name:ASMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-733-5334
Mailing Address - Street 1:41069 DEQUINDRE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-6730
Mailing Address - Country:US
Mailing Address - Phone:248-733-5334
Mailing Address - Fax:248-963-6215
Practice Address - Street 1:41069 DEQUINDRE RD STE 102
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-6730
Practice Address - Country:US
Practice Address - Phone:248-733-5334
Practice Address - Fax:248-963-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty