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Organization
CUSTOM REHAB SOLUTION INC
Active
Organization
CUSTOM REHAB SOLUTION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERIC HETHERWIXK (PRESIDENT)
(517) 945-4980
Entity
Organization
Contact information
Practice address
8250 LOCKERBIE RD, PARMA, MI 49269-9335
(517) 945-4980
Mailing address
8250 LOCKERBIE RD, PARMA, MI 49269-9335
(517) 945-4980
Taxonomy
Speciality
Code
Description
License number
State
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
5501006193
MI
Other
Enumeration date
07/24/2013
Last updated
11/28/2014
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