Provider Demographics
NPI:1801205745
Name:PROCARE INJURY & REHAB CENTERS LLC
Entity Type:Organization
Organization Name:PROCARE INJURY & REHAB CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-515-1128
Mailing Address - Street 1:1289 S LINDEN RD
Mailing Address - Street 2:STE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3499
Mailing Address - Country:US
Mailing Address - Phone:810-515-1128
Mailing Address - Fax:810-407-8009
Practice Address - Street 1:1289 S LINDEN RD
Practice Address - Street 2:STE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3499
Practice Address - Country:US
Practice Address - Phone:810-515-1128
Practice Address - Fax:810-407-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty