Healthcare Provider Details

I. General information

NPI: 1053704163
Provider Name (Legal Business Name): ANDREW MAGIRL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14755 215TH AVE
BIG RAPIDS MI
49307-9224
US

IV. Provider business mailing address

314 W CASS ST
GREENVILLE MI
48838-1766
US

V. Phone/Fax

Practice location:
  • Phone: 231-592-4234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501301770
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: