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General NPI Number Information
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NPI Number | 1205117512
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Entity Type | Individual
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Provider Name | TEGR MICHAEL POWELL DPT
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Gender | Male
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 1090 E DINUBA AVE
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City | REEDLEY
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State | CA
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Zip | 93654-3577
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Country | US
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Telephone | 559-638-3578
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Fax |
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Provider Business Mailing Address
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Address Line | 1939 ARGYLE AVE 41
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City | HOLLYWOOD
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State | CA
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Zip | 90068-3964
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Country | US
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Telephone |
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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 | 37879
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License Number State | CA
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