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General NPI Number Information
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NPI Number | 1104857804
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Entity Type | Organization
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Legal Business Name | FNI PHYSICAL MEDICINE & REHABILITATION, PC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4677 TOWNE CENTRE RD STE 104
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City | SAGINAW
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State | MI
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Zip | 48604-2847
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Country | US
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Telephone | 989-797-3129
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Fax | 989-797-3106
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Provider Business Mailing Address
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Address Line | 4677 TOWNE CENTRE RD STE 104
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City | SAGINAW
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State | MI
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Zip | 48604-2847
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Country | US
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Telephone | 989-797-3129
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Fax | 989-797-3106
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Authorized Official
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Title or Position | BUSINESS COORDINATOR
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Name | LISA J WIERSEMA
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Credential |
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Telephone | 989-797-3129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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