Healthcare Provider Details

I. General information

NPI: 1225229560
Provider Name (Legal Business Name): PHYSICAL THERAPY SERVICES OF LANSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3937 PATIENT CARE WAY SUITE 105
LANSING MI
48911-4287
US

IV. Provider business mailing address

6563 W MAIN ST SUITE: LOWER LEVEL
KALAMAZOO MI
49009-4051
US

V. Phone/Fax

Practice location:
  • Phone: 269-372-8483
  • Fax: 269-372-6113
Mailing address:
  • Phone: 269-372-8483
  • Fax: 269-372-6113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHY LOU CARRIER
Title or Position: MEMBER
Credential: PT
Phone: 269-372-8483