Organization
MICHIGAN PHYSICAL MEDICINE AND REHABILITATION, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE L BRADLEY D.O. (PRESIDENT)
(586) 468-3900
Entity
Organization
Contact information
Practice address
20950 HARRINGTON ST, CLINTON TOWNSHIP, MI 48036-1923
(586) 468-3900
(586) 468-9811
Mailing address
20950 HARRINGTON ST, CLINTON TWP, MI 48036-1923
(586) 468-3900
(586) 468-9811
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101012404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250E020580
BCBS PIN
MI
05
—
495487811
—
MI
Enumeration date
07/31/2006
Last updated
07/14/2008
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