Organization
RENEW REHABILITATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MORGAN GLAZER (AUTHORIZED OFFICIAL)
(248) 550-4800
Entity
Organization
Contact information
Practice address
24725 W 12 MILE RD STE 260, SOUTHFIELD, MI 48034-8310
(248) 382-8052
Mailing address
24725 W 12 MILE RD STE 260, SOUTHFIELD, MI 48034-8310
(248) 382-8052
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
07/20/2021
Last updated
05/20/2022
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