# TBCI PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Breaking Barriers Rehab Center (BBRC)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437228798
- **Authorized official:** DR. THOMAS T PARK MD (DIRECTOR)
- **Authorized official phone:** (248) 526-0110

## Contact information

- **Practice address:** 1059 OWENDALE, TROY, MI 48083
- **Practice address phone:** (248) 526-0110
- **Practice address fax:** (248) 680-9138
- **Mailing address:** 1059 OWENDALE, TROY, MI 48083
- **Mailing address phone:** (248) 526-0110
- **Mailing address fax:** (248) 680-9138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 01/27/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 30421 | BLUE CROSS | MI |