Organization
CENTER FOR SPORTS MEDICINE & FITNESS, INC.
Active
Other names
Procare Physical Therapy & rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
VIVEK SHIRISHKAR P.T. (PRESIDENT)
(248) 353-3260
Entity
Organization
Contact information
Practice address
18535 W 12 MILE RD STE B, LATHRUP VILLAGE, MI 48076-2664
(248) 353-3260
(888) 267-1867
Mailing address
18535 W 12 MILE RD STE B, LATHRUP VILLAGE, MI 48076-2664
(248) 353-3260
(888) 267-1867
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30499
BCBSM
MI
Enumeration date
04/17/2007
Last updated
07/08/2020
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