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General NPI Number Information
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NPI Number | 1003157587
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Entity Type | Organization
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Legal Business Name | CHEFF THERAPEUTIC RIDING CENTER
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 8450 N 43RD ST
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City | AUGUSTA
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State | MI
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Zip | 49012-9651
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Country | US
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Telephone | 269-731-4471
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Fax | 269-731-2990
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Provider Business Mailing Address
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Address Line | 8450 N 43RD ST
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City | AUGUSTA
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State | MI
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Zip | 49012-9651
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Country | US
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Telephone | 269-731-4471
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Fax | 269-731-2990
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | SANRA J CULVER
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Credential |
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Telephone | 269-731-4471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 01080764
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501005239
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License Number State | MI
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