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Organization
WEST MICHIGAN REHABILITATION CENTER INC
Active
Organization
WEST MICHIGAN REHABILITATION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PASUPATHY VADIVELU PT (PRESIDENT)
(616) 855-1900
Entity
Organization
Contact information
Practice address
585 36TH ST SW, WYOMING, MI 49509-4002
(616) 855-1900
(616) 855-0565
Mailing address
5825 POWDERHORN CT SW, WYOMING, MI 49418-9340
(616) 855-1900
(616) 855-0565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005841
MI
225100000X
Physical Therapist
5501015732
MI
Other
Enumeration date
10/26/2006
Last updated
08/13/2012
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