Provider Demographics
NPI:1942540703
Name:ATLAS REHAB INC
Entity Type:Organization
Organization Name:ATLAS REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:313-387-4430
Mailing Address - Street 1:26000 5 MILE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3236
Mailing Address - Country:US
Mailing Address - Phone:313-387-4430
Mailing Address - Fax:313-387-4010
Practice Address - Street 1:26000 5 MILE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3236
Practice Address - Country:US
Practice Address - Phone:313-387-4430
Practice Address - Fax:313-387-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty