Organization
TOTAL CARE PHYSICAL THERAPY & REHABILITATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIJAY MISHRA O.T. (ALTERNATE ADMINISTRATOR, OT)
(586) 872-5133
Entity
Organization
Contact information
Practice address
17950 WOODWARD AVE, 2ND FLOOR, DETROIT, MI 48203-2260
(313) 865-5200
(313) 865-5300
Mailing address
17950 WOODWARD AVE, 2ND FLOOR, DETROIT, MI 48203-2260
(313) 865-5200
(313) 865-5300
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30695
BCBS OF MICHIGAN
MA
01
—
5274758
AETNA
MA
01
—
P-236731
HAP
MI
01
—
P-63118
BLUE CARE NETWORK
MA
Enumeration date
07/07/2005
Last updated
07/21/2022
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