Premier Care Rehabilitation | |
10641 W Mcnichols Rd Detroit MI 48221-2303 | |
(313) 574-8205 | |
Not Available |
Full Name | Premier Care Rehabilitation |
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Speciality | Internal Medicine |
Location | 10641 W Mcnichols Rd, Detroit, Michigan |
Authorized Official Name and Position | Corina Malone (OWNER) |
Authorized Official Contact | 3135748205 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premier Care Rehabilitation 10641 W Mcnichols Rd Detroit MI 48221-2303 Ph: (313) 574-8205 | Premier Care Rehabilitation 10641 W Mcnichols Rd Detroit MI 48221-2303 Ph: (313) 574-8205 |
NPI Number | 1700304912 |
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Provider Enumeration Date | 09/07/2017 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 4981967254 |
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Medicare Enrollment ID | O20180419001199 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700304912 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Jack Rytel Kuc |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1871501221 PECOS PAC ID: 6709771082 Enrollment ID: I20040302001213 |
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