Organization
ACTIVE LIFE PHYSICAL THERAPY & REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ NIJJAR (CEO)
(734) 637-7540
Entity
Organization
Contact information
Practice address
17515 W 9 MILE RD STE 140, SOUTHFIELD, MI 48075-4411
(248) 281-4097
Mailing address
27320 DEBIASI DR, BROWNSTOWN, MI 48174-8511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
5501014085
MI
Other
Enumeration date
03/09/2018
Last updated
01/15/2025
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