Provider Demographics
NPI:1740336536
Name:MICHIGAN REHABILITATION SPECIALISTS OF WEBBERVILLE, INC.
Entity type:Organization
Organization Name:MICHIGAN REHABILITATION SPECIALISTS OF WEBBERVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:810-231-6904
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:WEBBERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48892-0500
Mailing Address - Country:US
Mailing Address - Phone:517-521-3524
Mailing Address - Fax:
Practice Address - Street 1:309 E GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:WEBBERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48892-8602
Practice Address - Country:US
Practice Address - Phone:517-521-3524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty