Provider Demographics
NPI:1669837084
Name:HUMAN BODY REHAB SERVICES PLLC
Entity Type:Organization
Organization Name:HUMAN BODY REHAB SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-971-5250
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2581
Mailing Address - Country:US
Mailing Address - Phone:248-971-5250
Mailing Address - Fax:734-451-0603
Practice Address - Street 1:4793 WALNUT CREEK DR
Practice Address - Street 2:
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3407
Practice Address - Country:US
Practice Address - Phone:248-971-5250
Practice Address - Fax:734-451-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5501004866261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGMedicare PIN