Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mi Sports Rehab PC

Organization Physical Therapist · NPI 1366718330

Mi Sports Rehab PC is a Physical Therapist 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
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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