Healthcare Provider Details
I. General information
NPI: 1003231671
Provider Name (Legal Business Name): GLOBAL PHYSICAL THERAPY AND SPINE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12235 S SAGINAW ST
GRAND BLANC MI
48439-1471
US
IV. Provider business mailing address
12235 S SAGINAW ST
GRAND BLANC MI
48439-1471
US
V. Phone/Fax
- Phone: 810-919-9459
- Fax: 810-636-7174
- Phone: 810-919-9459
- Fax: 810-636-7174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 5501005683 |
| License Number State | MI |
VIII. Authorized Official
Name:
RALPH
MCFARLAND
Title or Position: PRESIDENT
Credential: PT
Phone: 810-919-6459