Provider Demographics
NPI:1902783616
Name:PELVIC CORE REHABILITATION PLLC
Entity type:Organization
Organization Name:PELVIC CORE REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHWETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT,BCB-PMD
Authorized Official - Phone:248-662-7376
Mailing Address - Street 1:16340 MULBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-6836
Mailing Address - Country:US
Mailing Address - Phone:248-662-7376
Mailing Address - Fax:734-822-2038
Practice Address - Street 1:16340 MULBERRY WAY
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-6836
Practice Address - Country:US
Practice Address - Phone:248-662-7376
Practice Address - Fax:734-822-2038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty