Organization
RENAISSANCE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAHAT MALIK (ADMINISTRATOR)
(586) 775-5267
Entity
Organization
Contact information
Practice address
30200 SCHOENHERR, WARREN, MI 48093
(586) 775-5267
(586) 775-2331
Mailing address
30020 SCHOENHERR, WARREN, MI 48093
(586) 775-5267
(586) 775-2331
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4792395
—
MI
01
—
71010000030669
BCBS
MI
Enumeration date
07/11/2006
Last updated
08/22/2020
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