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Organization

MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE, LLC

Active
Other names
ATI Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN MCGIVERN CCO (CHIEF COMPLIANCE OFFICER)
(630) 296-2222
Entity
Organization

Contact information

Practice address
1949 W MAPLE RD, TROY, MI 48084-7109
(248) 268-5497
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
MI
225X00000X
Occupational Therapist
MI
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MI

Other

Enumeration date
03/04/2014
Last updated
05/03/2018
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