Provider Demographics
NPI:1427226083
Name:MICHIGAN REHABILITATION SPECIALISTS, LLC
Entity Type:Organization
Organization Name:MICHIGAN REHABILITATION SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:810-231-6904
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48139-0215
Mailing Address - Country:US
Mailing Address - Phone:810-231-6904
Mailing Address - Fax:810-231-6906
Practice Address - Street 1:10020 PROFESSIONAL CENTER DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMBURG
Practice Address - State:MI
Practice Address - Zip Code:48139
Practice Address - Country:US
Practice Address - Phone:810-231-6904
Practice Address - Fax:810-231-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty