Provider Demographics
NPI:1043651979
Name:MERIDIAN REHAB LLC
Entity type:Organization
Organization Name:MERIDIAN REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:VASUDEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SURYAKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:734-680-8626
Mailing Address - Street 1:33000 PALMER RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5517
Mailing Address - Country:US
Mailing Address - Phone:734-680-8626
Mailing Address - Fax:734-680-8676
Practice Address - Street 1:33000 PALMER RD
Practice Address - Street 2:SUITE #2
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5517
Practice Address - Country:US
Practice Address - Phone:734-680-8626
Practice Address - Fax:734-680-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty