Organization
INTERSTATE REHAB INC
Active
Organization
INTERSTATE REHAB INC
Active
Other names
Essenza Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDO B. CARBONELL DPT (ASSOCIATE)
(586) 530-7114
Entity
Organization
Contact information
Practice address
16910 W 10 MILE RD STE 101, SOUTHFIELD, MI 48075-2920
(734) 341-8068
Mailing address
16910 W 10 MILE RD STE 101, SOUTHFIELD, MI 48075-2920
(734) 341-8068
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2011
Last updated
10/30/2023
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