Organization
GREATER METRO REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARCIA FOSNAUGH AVIS R.N. (CLINIC DIRECTOR)
(248) 353-6880
Entity
Organization
Contact information
Practice address
20240 W 12 MILE RD, SOUTHFIELD, MI 48076-2426
(248) 353-6880
(734) 692-6195
Mailing address
210 WOODBERRY DR, BLOOMFIELD HILLS, MI 48304-3561
(248) 353-6880
(734) 692-6195
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
A106496
MI
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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