Healthcare Provider Details

I. General information

NPI: 1780687095
Provider Name (Legal Business Name): ABBY D CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 MITCHELL PARK DR STE 14
PETOSKEY MI
49770-8674
US

IV. Provider business mailing address

2206 MITCHELL PARK DR STE 14
PETOSKEY MI
49770-8674
US

V. Phone/Fax

Practice location:
  • Phone: 231-348-7777
  • Fax: 231-348-3177
Mailing address:
  • Phone: 231-348-7777
  • Fax: 231-348-3177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. LAURA ELISABETH LENKEY
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 231-348-7777