Macomb Physical Therapy & Rehab LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

MACOMB PHYSICAL THERAPY & REHAB LLC

Practice address

14207 Ford Rd
Dearborn, MI 48126-3148

Phone

(248) 635-3413

NPI assigned

Jan 5, 2016

Organization subpart

No

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

Authorized official

Name

Krisitna Etanislao

Title

Billing Manager

Phone

(248) 635-3413

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1780040824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14207 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14207 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263148",
            "telephone_number": "248-635-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB PHYSICAL THERAPY & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "ETANISLAO",
        "authorized_official_first_name": "KRISITNA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "248-635-3413"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rima Machhour
• Michele L Mack, CRNA
• Fatmeh Mackie
• Tamara Mackie, DDS
• Miranda M Macko, AGNP-C
• Haris C. Macris, M.D.
• Rashad Ghassan Madarani I
• Briana Maddux
• Ayeda Madhigi
• Samyuktha R Madishetty I, M.D.

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.