Organization
CLARKSTON PHYSICAL THERAPY AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASIF M CHAUDHRY PT (ADMINISTRATOR)
(313) 862-1419
Entity
Organization
Contact information
Practice address
18272 LIVERNOIS AVE, DETROIT, MI 48221-2773
(313) 862-1419
(313) 862-2476
Mailing address
18272 LIVERNOIS AVE, DETROIT, MI 48221-2773
(313) 862-1419
(313) 862-2476
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
236761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236761/ 1932327327
OPT
MI
Enumeration date
04/23/2007
Last updated
08/16/2013
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