MEDICARE: MS. MICHELLE MARIE MCCORMICK PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8775	NC
2	225100000X	Physical Therapist	6215	MN
3	225100000X	Physical Therapist	1491	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	078TN	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1972560761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE MARIE MCCORMICK PT

Provider Business Mailing Address
First Line	:	PO BOX 1460
Second Line	:
City	:	ABERDEEN
State	:	SD
Zip	:	57402-1460
Country	:	US
Telephone Number	:	605-622-2857
Fax Number	:	605-622-2859

Provider Business Practice Location Address
First Line	:	1516 4TH ST NE
Second Line	:
City	:	WATERTOWN
State	:	SD
Zip	:	57201-6824
Country	:	US
Telephone Number	:	605-753-0430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	05/10/2016

Similar Medicare Providers

1235135765 — MR. NATHAN LEE BRESKE DPT, ATC
Practice Location Address:

1516 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-753-0430
Practice Fax: 605-753-2663

1184660151 — INNOVATIVE PROCEDURAL CENTER LLC
Practice Location Address:

1512 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-884-0100
Practice Fax:

1003851163 — INNOVATIVE PAIN CENTER LLC
Practice Location Address:

1512 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-884-0100
Practice Fax:

1376588434 — PATRICK L RETTERATH MD
Practice Location Address:

1512 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-884-0100
Practice Fax:

1487674305 — BRUCE M SIEGLING OD
Practice Location Address:

1520 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-882-1818
Practice Fax:

1144396102 — AVERA HOME MEDICAL EQUIPMENT, LLC
Practice Location Address:

1508 4TH ST NE
WATERTOWN, SD
57201-6824

Practice Phone: 605-882-3511
Practice Fax: 605-882-3062

Directions to “ MS. MICHELLE MARIE MCCORMICK PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.