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General NPI Number Information
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NPI Number | 1083706584
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY CENTER OF MIDLAND, LLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 6105 JEFFERSON AVE
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City | MIDLAND
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State | MI
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Zip | 48640-2935
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Country | US
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Telephone | 989-839-9309
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Fax | 989-633-9170
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Provider Business Mailing Address
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Address Line | 6105 JEFFERSON AVE
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City | MIDLAND
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State | MI
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Zip | 48640-2935
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Country | US
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Telephone | 989-839-8309
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Fax | 989-633-9170
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Authorized Official
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Title or Position | OWNER
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Name | MISS LAURA ANNE-HALL MCGUIRE
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Credential | P.T.
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Telephone | 989-839-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501003922
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License Number State | MI
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