Mi Sports Rehab P.C

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501006291 Issued in MI

Legal business name

MI SPORTS REHAB P.C

Practice address

25865 W 12 Mile Rd
Suite 104
Southfield, MI 48034-1817

Phone

(248) 208-7492

Fax

(248) 208-7494

NPI assigned

Mar 23, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vinoth S Purusothaman, PT, DPT

Title

President

Phone

(248) 208-7492

Specialties & licenses 5

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1366718330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "address_2": "SUITE 104",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-208-7492",
            "fax_number": "248-208-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "address_2": "SUITE 104",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-208-7492",
            "fax_number": "248-208-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI SPORTS REHAB P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "PURUSOTHAMAN",
        "authorized_official_first_name": "VINOTH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-208-7492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006291",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006612",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006095",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000744",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12080163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mi Healthcare Professionals PC (Millennium Urgent Care)
• Mi House Physician PC
• Mi Spinecare Professional Corporation (Mi Spinecare)
• Mi Wellness Clinic Professional Corporation (MI Wellness Clinic)
• Raven Mial
• Michael J. Freedman, MD, P.C.
• Daniel Michael, MD
• Deborah A Michael, PA-C

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.