Provider Demographics
NPI:1447425848
Name:MICHIGAN REHABILITATION SPECIALISTS OF PINCKNEY LLC
Entity Type:Organization
Organization Name:MICHIGAN REHABILITATION SPECIALISTS OF PINCKNEY LLC
Other - Org Name:MICHIGAN REHABILITATION SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
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 1:1201 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8133
Mailing Address - Country:US
Mailing Address - Phone:734-648-0138
Mailing Address - Fax:734-648-0140
Practice Address - Street 1:1201 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-8133
Practice Address - Country:US
Practice Address - Phone:734-648-0138
Practice Address - Fax:734-648-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty