Organization
PHYSICAL MEDICINE, P.C.
Active
Other names
Jack Belen, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK G. BELEN M.D. (PRESIDENT)
(248) 365-6661
Entity
Organization
Contact information
Practice address
20307 W 12 MILE RD, STE. 102, SOUTHFIELD, MI 48076-5407
(248) 356-6661
(248) 356-6619
Mailing address
20307 W. 12 MILE, STE. 102, SOUTHFIELD, MI 48076
(248) 356-6661
(248) 356-6619
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
042374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1552582
—
MI
Enumeration date
01/17/2008
Last updated
01/17/2008
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