Provider Demographics
NPI:1639256902
Name:REHABILITATION & PHYSICAL MEDICINE SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:REHABILITATION & PHYSICAL MEDICINE SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-459-0801
Mailing Address - Street 1:350 LAFAYETTE AVE SE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4600
Mailing Address - Country:US
Mailing Address - Phone:616-459-0801
Mailing Address - Fax:616-459-4065
Practice Address - Street 1:350 LAFAYETTE AVE SE
Practice Address - Street 2:SUITE 301
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4600
Practice Address - Country:US
Practice Address - Phone:616-459-0801
Practice Address - Fax:616-459-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty