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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