Provider Demographics
NPI:1982092268
Name:PACE PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:PACE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:313-438-0963
Mailing Address - Street 1:8338 ALLEN RD
Mailing Address - Street 2:SUITE 102B
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1399
Mailing Address - Country:US
Mailing Address - Phone:313-438-0963
Mailing Address - Fax:313-438-0974
Practice Address - Street 1:8338 ALLEN RD
Practice Address - Street 2:SUITE 102B
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1399
Practice Address - Country:US
Practice Address - Phone:313-438-0963
Practice Address - Fax:313-438-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI8409Medicare PIN