Organization
MICHIGAN ORTHOPEDIC REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK S FUQUA (OWNER)
(248) 566-3525
Entity
Organization
Contact information
Practice address
4401 W 13 MILE RD, ROYAL OAK, MI 48073-6516
(248) 566-3525
(248) 566-3527
Mailing address
4401 W 13 MILE RD, ROYAL OAK, MI 48073-6516
(248) 566-3525
(248) 566-3527
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
02/15/2024
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