Provider Demographics
NPI:1508244567
Name:REHAB PHYSICIANS OF METRO DETROIT
Entity Type:Organization
Organization Name:REHAB PHYSICIANS OF METRO DETROIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBANA-JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-618-0226
Mailing Address - Street 1:22972 LAHSER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-4408
Mailing Address - Country:US
Mailing Address - Phone:313-618-0226
Mailing Address - Fax:248-809-6566
Practice Address - Street 1:22972 LAHSER RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4408
Practice Address - Country:US
Practice Address - Phone:313-618-0226
Practice Address - Fax:248-809-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty