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Organization

PORT HURON THERAPY CENTER LLC

Active
Other names
Midwest Therapy Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MUHAMMAD ZAFAR (PRESIDENT / CEO)
(810) 385-9808
Entity
Organization

Contact information

Practice address
34051 GRATIOT AVE, SUITE 103, CLINTON TOWNSHIP, MI 48035-3592
(810) 385-9808
(586) 415-7800
Mailing address
34051 GRATIOT AVE, SUITE 103, CLINTON TOWNSHIP, MI 48035-3592
(810) 385-9808
(586) 415-7800

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
MI
385H00000X
Respite Care
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137801
CARE CHOICES PPO
MI
05
142585
MI
01
234528
HEALTH ALLIANCE PLAN
MI
05
30322
MI
01
30426
BLUE CROSS BLUE SHIELD
MI
05
4704356
MI
01
5135045
CIGNA PPO
MI
Enumeration date
05/19/2006
Last updated
01/30/2013
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