Organization
DYNAMIC REHAB, LLC
Active
Organization
DYNAMIC REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUJIT JOHN (ADMIN)
(248) 233-6467
Entity
Organization
Contact information
Practice address
15700 PROVIDENCE DR, 400, SOUTHFIELD, MI 48075-3144
(248) 233-6467
(248) 415-6289
Mailing address
15700 PROVIDENCE DR, 400, SOUTHFIELD, MI 48075-3144
(248) 233-6467
(248) 415-6289
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
MI
251C00000X
Developmentally Disabled Services Day Training Agency
—
MI
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MI
332B00000X
Durable Medical Equipment & Medical Supplies
—
MI
347C00000X
Private Vehicle
—
MI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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