Provider Demographics
NPI:1689616161
Name:VALLEY PHYSICAL THERAPY PAIN CLINIC & REHAB INC
Entity Type:Organization
Organization Name:VALLEY PHYSICAL THERAPY PAIN CLINIC & REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-497-0726
Mailing Address - Street 1:138 HARROW LN STE 2
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6061
Mailing Address - Country:US
Mailing Address - Phone:989-497-0726
Mailing Address - Fax:989-401-7502
Practice Address - Street 1:138 HARROW LN STE 2
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6061
Practice Address - Country:US
Practice Address - Phone:989-497-0726
Practice Address - Fax:989-401-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI404679880Medicaid
MI236786Medicare ID - Type Unspecified