Organization
REHABILITATION MEDICINE PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMEN VENTOCILLA MD (PRESIDENT)
(517) 351-8123
Entity
Organization
Contact information
Practice address
3960 PATIENT CARE WAY, SUITE 102, LANSING, MI 48911-4275
(517) 351-8123
(517) 351-1352
Mailing address
3960 PATIENT CARE WAY, SUITE 102, LANSING, MI 48911-4275
(517) 351-8123
(517) 351-1352
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
CV405064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0331111
BCBSM
MI
01
—
25008734
RAILROAD MEDICARE
MI
Enumeration date
06/05/2006
Last updated
11/06/2007
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