NPI 1093687642

Mustafa Ettaher

Practitioner Physical Therapist Redford, MI

Practice location

Address: 14615 Telegraph Rd, Redford, MI 48239-3300
Phone: (313) 334-4298
Fax: (313) 209-7676
Mailing address: 2122 York Rd STE 300, Oak Brook, IL 60523-1925

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

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Registry record

NPI: 1093687642
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Sep 2025
Record last updated: 23 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.