Soul Physical Therapy Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOUL PHYSICAL THERAPY CENTER

Practice address

6558 Greenfield Rd
Dearborn, MI 48126-1701

Phone

(313) 581-1155

Fax

(313) 581-1144

NPI assigned

Feb 11, 2018

Organization subpart

No

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

Authorized official

Name

Ameneh Rezvan

Title

President/ Manager

Phone

(248) 884-0048

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muhammad Shabbir Malik

  • Physical Therapist
  • Troy, MI
  • NPI 1023519881
  NPD (past)

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

{
    "created_epoch": "1518307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518307200000",
    "number": "1811496359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481210086",
            "telephone_number": "313-581-1155",
            "fax_number": "313-581-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6558 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261701",
            "telephone_number": "313-581-1155",
            "fax_number": "313-581-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL PHYSICAL THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-11",
        "last_updated": "2018-02-11",
        "status": "A",
        "authorized_official_last_name": "REZVAN",
        "authorized_official_first_name": "AMENEH",
        "authorized_official_title_or_position": "PRESIDENT/ MANAGER",
        "authorized_official_telephone_number": "248-884-0048"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Gene Sorenson
• Jonathan Robert Sorini, D.O.
• Kathryn Elise Sorini, AGACNP-BC
• Hoda Souhouba
• Zahra Soukar-Kadour
• Soul Physical Therapy Center LLC
• Mamoun Mousa Souleiman, MD
• Mark Soutar, LLP
• South Dearborn Pharmacy,Inc
• Abigail Channing Southard, MSN, CNM, C-EFM

• Physical Therapy Clinic/Center in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2018; 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.