Provider Demographics
NPI:1730588997
Name:MAYAS REHAB & PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:MAYAS REHAB & PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-826-1835
Mailing Address - Street 1:11843 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3053
Mailing Address - Country:US
Mailing Address - Phone:313-826-1835
Mailing Address - Fax:313-826-1958
Practice Address - Street 1:11843 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3053
Practice Address - Country:US
Practice Address - Phone:313-826-1835
Practice Address - Fax:313-826-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGMedicare PIN