Healthcare Provider Details

I. General information

NPI: 1245519602
Provider Name (Legal Business Name): MEHGAN KRICK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 MAIN ST
BROWN CITY MI
48416
US

IV. Provider business mailing address

3655 EARL WEST RD
BROWN CITY MI
48416-9684
US

V. Phone/Fax

Practice location:
  • Phone: 810-356-7441
  • Fax: 810-272-4407
Mailing address:
  • Phone: 810-356-7441
  • Fax: 810-227-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: