Provider Demographics
NPI:1689910671
Name:HORIZON REHAB SPECIALISTS
Entity Type:Organization
Organization Name:HORIZON REHAB SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRZEGORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAWISLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-967-2266
Mailing Address - Street 1:22150 GREENFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2535
Mailing Address - Country:US
Mailing Address - Phone:248-967-2273
Mailing Address - Fax:248-967-2266
Practice Address - Street 1:2055 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0327
Practice Address - Country:US
Practice Address - Phone:248-967-2273
Practice Address - Fax:248-967-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty