Organization
PRIME REHAB AND PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMAD SADIQ (ADMINISTRATOR)
(313) 357-3079
Entity
Organization
Contact information
Practice address
2900 S FORT ST, STE 3, DETROIT, MI 48217-1061
(313) 388-0156
(313) 388-0593
Mailing address
7140 W FORT ST, STE 4, DETROIT, MI 48209-2917
(313) 357-3079
(313) 388-0593
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4676467
—
MI
Enumeration date
06/16/2005
Last updated
03/07/2012
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