Provider Demographics
NPI:1659787984
Name:WOODWARD REHABILITATION PC
Entity Type:Organization
Organization Name:WOODWARD REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-268-3770
Mailing Address - Street 1:1200 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2454
Mailing Address - Country:US
Mailing Address - Phone:248-268-3770
Mailing Address - Fax:248-268-3771
Practice Address - Street 1:1200 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2454
Practice Address - Country:US
Practice Address - Phone:248-268-3770
Practice Address - Fax:248-268-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010050261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center