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

Spine Sports & Occupational Medicine PC

Organization Physical Medicine & Rehabilitation Physician · NPI 1962571125

Spine Sports & Occupational Medicine PC is a Physical Medicine & Rehabilitation Physician in Allen Park, Michigan. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

15636 Southfield Rd
Allen Park, MI 48101-2513
Phone: (313) 928-0700
Fax: (313) 928-0701
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Comprehensive Outpatient Rehabilitation Facility (CORF) Taxonomy 261QR0401X

Record details

NPI number1962571125
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fatmeh Niskar — Owner · (313) 928-0700
NPI enumeratedNovember 6, 2006
Last updated in NPPESFebruary 2, 2024
Certification dateFebruary 2, 2024
Mailing address15636 Southfield Rd, Allen Park, MI 48101-2513

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