Organization
ADVANCED NEURO REHAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOHNSON (OFFICE MANAGER)
(248) 548-6400
Entity
Organization
Contact information
Practice address
26635 WOODWARD AVENUE, SUITE 101, HUNTINGTON WOODS, MI 48070
(248) 548-6400
(248) 548-8885
Mailing address
26635 WOODWARD AVENUE, SUITE 101, HUNTINGTON WOODS, MI 48070-1372
(248) 548-6400
(248) 548-8885
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
HP050806-4301050806
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4377860
—
MI
Enumeration date
01/29/2007
Last updated
06/12/2008
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