Provider Demographics
NPI:1124325774
Name:MAX REHAB PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:MAX REHAB PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LABIB
Authorized Official - Suffix:
Authorized Official - Credentials:RPT, DPT
Authorized Official - Phone:248-629-4011
Mailing Address - Street 1:28051 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3016
Mailing Address - Country:US
Mailing Address - Phone:248-629-4011
Mailing Address - Fax:248-629-4010
Practice Address - Street 1:28051 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3016
Practice Address - Country:US
Practice Address - Phone:248-629-4011
Practice Address - Fax:248-629-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011866261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center