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Organization
SOUTHFIELD CENTER FOR INTERGRATED MUSCULOSKELETAL INJURY PC
Active
Organization
SOUTHFIELD CENTER FOR INTERGRATED MUSCULOSKELETAL INJURY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SUPER DC (PRESIDENT)
(917) 449-7582
Entity
Organization
Contact information
Practice address
26400 LAHSER RD STE 100, SOUTHFIELD, MI 48033-2672
(917) 449-7582
Mailing address
602 VIENTO DE AVILA, TAMPA, FL 33613-5229
(917) 449-7582
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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