# CUSTOM REHAB SOLUTION INC

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

## Provider details

- **NPI number:** 1306288931
- **Authorized official:** FREDERIC HETHERWIXK (PRESIDENT)
- **Authorized official phone:** (517) 945-4980

## Contact information

- **Practice address:** 8250 LOCKERBIE RD, PARMA, MI 49269-9335
- **Practice address phone:** (517) 945-4980
- **Mailing address:** 8250 LOCKERBIE RD, PARMA, MI 49269-9335
- **Mailing address phone:** (517) 945-4980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251E1300X | Clinical Electrophysiology Physical Therapist | 5501006193 | MI | Yes |

## Other

- **Enumeration date:** 07/24/2013
- **Last updated:** 11/28/2014