# MIDWEST PHYSICAL MEDICINE AND REHABILITATION PLLC

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

## Provider details

- **NPI number:** 1225146657
- **Authorized official:** DR. MONICA GREEN M.D. (PRESIDENT)
- **Authorized official phone:** (734) 542-1970

## Contact information

- **Practice address:** 14555 LEVAN RD, SUITE 314, LIVONIA, MI 48154-5083
- **Practice address phone:** (734) 542-1970
- **Practice address fax:** (248) 614-9756
- **Mailing address:** PO BOX 285, TROY, MI 48099-0285
- **Mailing address phone:** (734) 542-1970
- **Mailing address fax:** (248) 614-9756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4301076422 | MI | Yes |

## Other

- **Enumeration date:** 08/27/2006
- **Last updated:** 07/06/2015