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Organization

CHILDRENS REHAB CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA SAND (CREDENTIALING SPECIALIST)
(810) 875-9186
Entity
Organization

Contact information

Practice address
324 N MAIN ST, DAVISON, MI 48423
(810) 836-6685
Mailing address
324 N MAIN ST, DAVISON, MI 48423-1434

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
7101003983
MI
261QX0100X
Occupational Medicine Clinic/Center

Other

Enumeration date
11/17/2014
Last updated
06/28/2018
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