Provider Demographics
NPI:1902467145
Name:HALO PT & REHAB
Entity Type:Organization
Organization Name:HALO PT & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HANADY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYDOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-993-7777
Mailing Address - Street 1:PO BOX 772249
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2249
Mailing Address - Country:US
Mailing Address - Phone:248-331-1400
Mailing Address - Fax:
Practice Address - Street 1:20240 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2426
Practice Address - Country:US
Practice Address - Phone:248-331-1400
Practice Address - Fax:248-331-1401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALO MEDICAL GROUP PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty