Provider Demographics
NPI:1528895364
Name:KULSUM PELVIC REHAB SERVICES
Entity type:Organization
Organization Name:KULSUM PELVIC REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMEENA
Authorized Official - Middle Name:KULSUM
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-212-4203
Mailing Address - Street 1:2661 AUBREY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-2702
Mailing Address - Country:US
Mailing Address - Phone:248-212-4203
Mailing Address - Fax:
Practice Address - Street 1:4405 S BALDWIN RD STE E
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-2164
Practice Address - Country:US
Practice Address - Phone:248-972-5088
Practice Address - Fax:888-614-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty