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Organization
SPINE SPORTS & OCCUPATIONAL MEDICINE P.C.
Active
Organization
SPINE SPORTS & OCCUPATIONAL MEDICINE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FATMEH NISKAR (OWNER)
(313) 928-0700
Entity
Organization
Contact information
Practice address
15636 SOUTHFIELD RD, ALLEN PARK, MI 48101-2513
(313) 928-0700
(313) 928-0701
Mailing address
15636 SOUTHFIELD RD, ALLEN PARK, MI 48101-2513
(313) 928-0700
(313) 928-0701
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NULL
Other
Enumeration date
11/06/2006
Last updated
02/02/2024
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