Organization
SPECTRUM REHABILITATION CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY G SEWICK PHD (OWNER)
(248) 350-3650
Entity
Organization
Contact information
Practice address
26555 EVERGREEN RD, STE 830, SOUTHFIELD, MI 48076-4206
(248) 350-3650
(248) 350-1216
Mailing address
26555 EVERGREEN RD, STE 830, SOUTHFIELD, MI 48076-4206
(248) 350-3650
(248) 350-1216
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301005256
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1193960001
—
MI
Enumeration date
11/03/2005
Last updated
05/24/2021
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