Organization
TBCI PC
Active
Other names
Breaking Barriers Rehab Center (BBRC)
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS T PARK MD (DIRECTOR)
(248) 526-0110
Entity
Organization
Contact information
Practice address
1059 OWENDALE, TROY, MI 48083
(248) 526-0110
(248) 680-9138
Mailing address
1059 OWENDALE, TROY, MI 48083
(248) 526-0110
(248) 680-9138
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30421
BLUE CROSS
MI
Enumeration date
11/08/2006
Last updated
01/27/2009
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