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General NPI Number Information
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NPI Number | 1073339685
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Entity Type | Individual
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Provider Name | PAITON RELYIN PLUTCHAK PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 841 W WASHINGTON ST
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City | MARQUETTE
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State | MI
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Zip | 49855-4119
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Country | US
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Telephone | 906-228-2595
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Fax |
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Provider Business Mailing Address
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Address Line | 1885 HARBOR VISTA DR APT 2E
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City | MARQUETTE
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State | MI
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Zip | 49855-5086
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Country | US
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Telephone | 906-290-2146
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5501303368
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License Number State | MI
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