Provider Demographics
NPI:1902081839
Name:AMTY REHAB SERVICES
Entity Type:Organization
Organization Name:AMTY REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADELEKE
Authorized Official - Middle Name:MONSURU
Authorized Official - Last Name:YEKINNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-680-9216
Mailing Address - Street 1:21500 GREENFIELD RD STE 216
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-3009
Mailing Address - Country:US
Mailing Address - Phone:313-680-9216
Mailing Address - Fax:
Practice Address - Street 1:21500 GREENFIELD RD STE 216
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-3009
Practice Address - Country:US
Practice Address - Phone:313-680-9216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty