Provider Demographics
NPI:1518047893
Name:TRI-COUNTY PHYSICAL THERAPY & REHABILITATION INC.
Entity Type:Organization
Organization Name:TRI-COUNTY PHYSICAL THERAPY & REHABILITATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAHZIBUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:313-493-3705
Mailing Address - Street 1:15800 W MCNICHOLS RD
Mailing Address - Street 2:STE 113
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3566
Mailing Address - Country:US
Mailing Address - Phone:313-493-3705
Mailing Address - Fax:313-272-9418
Practice Address - Street 1:15800 W MCNICHOLS RD
Practice Address - Street 2:STE 113
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3566
Practice Address - Country:US
Practice Address - Phone:313-493-3705
Practice Address - Fax:313-272-9418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-6655Medicare ID - Type UnspecifiedPHYSICAL THERAPY