Organization
SOUL PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMENEH REZVAN (PRESIDENT/ MANAGER)
(248) 884-0048
Entity
Organization
Contact information
Practice address
6558 GREENFIELD RD, DEARBORN, MI 48126-1701
(313) 581-1155
(313) 581-1144
Mailing address
PO BOX 86, DEARBORN, MI 48121-0086
(313) 581-1155
(313) 581-1144
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/11/2018
Last updated
02/11/2018
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