Provider Demographics
NPI:1942343009
Name:OAKLAND PHYSICAL THERAPY AND REHABILITATION ,INC
Entity Type:Organization
Organization Name:OAKLAND PHYSICAL THERAPY AND REHABILITATION ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-443-8091
Mailing Address - Street 1:24450 EVERGREEN RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5518
Mailing Address - Country:US
Mailing Address - Phone:248-443-8091
Mailing Address - Fax:248-443-8092
Practice Address - Street 1:24450 EVERGREEN RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5518
Practice Address - Country:US
Practice Address - Phone:248-443-8091
Practice Address - Fax:248-443-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI236715261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30672OtherBCBS
236715Medicare Oscar/Certification