Provider Demographics
NPI:1851550883
Name:ALL-PRO OCCUPATIONAL REHAB LLC
Entity Type:Organization
Organization Name:ALL-PRO OCCUPATIONAL REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:PRAMOD
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:313-962-9050
Mailing Address - Street 1:1331 TRUMBULL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1389
Mailing Address - Country:US
Mailing Address - Phone:313-962-9050
Mailing Address - Fax:313-962-9053
Practice Address - Street 1:1331 TRUMBULL ST STE 300
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48216-1389
Practice Address - Country:US
Practice Address - Phone:313-962-9050
Practice Address - Fax:313-962-9053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty