Provider Demographics
NPI:1245048362
Name:RELIVE PHYSICAL THERAPY AND REHABILITATION
Entity type:Organization
Organization Name:RELIVE PHYSICAL THERAPY AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHINZE
Authorized Official - Middle Name:C
Authorized Official - Last Name:OUSUAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-968-5600
Mailing Address - Street 1:21700 GREENFIELD RD STE 257
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2532
Mailing Address - Country:US
Mailing Address - Phone:248-968-5600
Mailing Address - Fax:248-968-5616
Practice Address - Street 1:21700 GREENFIELD RD STE 257
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2532
Practice Address - Country:US
Practice Address - Phone:248-968-5600
Practice Address - Fax:248-968-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty