# ACTIVE PHYSICAL THERAPY AND REHAB SERVICES INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053364679
- **Authorized official:** MRS. CHAMUNDEESWARI MUTHUVINAYAGAM PHYSICALTHERAPIST (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (810) 966-8500

## Contact information

- **Practice address:** 718 HURON AVE, PORT HURON, MI 48060-3704
- **Practice address phone:** (810) 966-8500
- **Practice address fax:** (810) 966-8600
- **Mailing address:** 718 HURON AVE, PORT HURON, MI 48060-3704
- **Mailing address phone:** (810) 966-8500
- **Mailing address fax:** (810) 966-8600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | N/A | NULL | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 03/14/2016