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General NPI Number Information
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NPI Number | 1023193497
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Entity Type | Organization
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Legal Business Name | ASPEN PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 1325 S OTSEGO AVE
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City | GAYLORD
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State | MI
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Zip | 49735-7749
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Country | US
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Telephone | 989-705-2700
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Fax | 989-705-2727
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Provider Business Mailing Address
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Address Line | PO BOX 519
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City | GAYLORD
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State | MI
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Zip | 49734-0519
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Country | US
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Telephone | 989-705-2700
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Fax | 989-705-2727
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARTIN FOOTE
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Credential | M.S.P.T.
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Telephone | 989-705-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501008967
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License Number State | MI
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