Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mi Sports Rehab PC

Organization Physical Therapist · NPI 1366718330

Mi Sports Rehab PC provides Physical Therapist services in Southfield, Michigan. Licensed in Michigan. Registered with an NPI since 2012.

Licensed in
MI
In the registry since
2012
Specialties on file
5
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25865 W 12 Mile Rd Ste 104
Southfield, MI 48034-1817 Not confirmed with CMS for 14 years — call before visiting
Phone: (248) 208-7492
Fax: (248) 208-7494
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501006291 (MI)
Physical Therapist Taxonomy 225100000X · Licence 5501006612 (MI)
Physical Therapist Taxonomy 225100000X · Licence 5501006095 (MI)
Occupational Therapist Taxonomy 225X00000X · Licence 5201000744 (MI)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 12080163 (MI)

Record details

NPI number1366718330
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vinoth Purusothaman — President · (248) 208-7492
NPI enumeratedMarch 23, 2012
Last updated in NPPESMarch 23, 2012
Mailing address25865 W 12 Mile Rd, Suite 104, Southfield, MI 48034-1817

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