Organization
CENTER FOR PHYSICAL MEDICINE AND REHABILITATION PC
Active
Organization
CENTER FOR PHYSICAL MEDICINE AND REHABILITATION PC
Active
Other names
Complete Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ALAN KRASNICK MD (PRESIDENT)
(586) 552-4499
Entity
Organization
Contact information
Practice address
13850 E 12 MILE RD, STE 2-B, WARREN, MI 48088-3730
(586) 552-4499
(586) 552-4878
Mailing address
13850 E 12 MILE RD, WARREN, MI 48088-3730
(586) 552-4499
(586) 552-4878
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540E020680
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/26/2007
Last updated
12/26/2007
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