Healthcare Provider Details

I. General information

NPI: 1740245588
Provider Name (Legal Business Name): NATALIE JEANNE KARPOVICH MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 12/01/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 N SAGINAW ST STE B
HOLLY MI
48442-1379
US

IV. Provider business mailing address

8911 STONEWALL W.
CLARKSTON MI
48348-5162
US

V. Phone/Fax

Practice location:
  • Phone: 248-625-5998
  • Fax: 248-625-3975
Mailing address:
  • Phone: 248-408-7027
  • Fax: 248-634-5995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501012034
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: