Organization
SOUTHFIELD CENTER FOR INTERGRATED MUSCULOSKELETAL INJURY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SUPER DC (PRESIDENT)
(917) 449-7582
Entity
Organization
Contact information
Practice address
26400 LAHSER RD STE 100, SOUTHFIELD, MI 48033-2672
(917) 449-7582
Mailing address
602 VIENTO DE AVILA, TAMPA, FL 33613-5229
(917) 449-7582
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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