Organization
MICHIGAN SPINE & ORTHOPEDIC REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J JOHNSON MS, PT (PRESIDENT)
(734) 572-9800
Entity
Organization
Contact information
Practice address
4918 W CLARK RD, STE 102, YPSILANTI, MI 48197-1142
(734) 572-9800
(734) 572-0762
Mailing address
4918 W CLARK RD, STE 102, YPSILANTI, MI 48197-1142
(734) 572-9800
(734) 572-0762
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501003609
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100136
CARE CHOICES
—
01
—
30382
BCBS
MI
01
—
366180
HAP
MI
01
—
5691619
AETNA
—
01
—
RT810006
M CARE
MI
Enumeration date
08/02/2005
Last updated
05/12/2010
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