Provider Demographics
NPI:1376173161
Name:PERSONAL INJURY PHYSICAL THERAPY & REHAB LLC
Entity Type:Organization
Organization Name:PERSONAL INJURY PHYSICAL THERAPY & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-870-7000
Mailing Address - Street 1:28763 NORTHWESTERN HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1842
Mailing Address - Country:US
Mailing Address - Phone:248-870-7000
Mailing Address - Fax:
Practice Address - Street 1:PERSONAL INJURY PHYSICAL THERAPY & REHAB LLC
Practice Address - Street 2:28763 NORTHWESTERN HWY, STE 101
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1842
Practice Address - Country:US
Practice Address - Phone:248-870-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty