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General NPI Number Information
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NPI Number | 1245495779
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Entity Type | Organization
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Legal Business Name | SUMMIT PHYSICAL THERAPY PROFESSIONALS, LLC
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 11/11/2008
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Provider Practice Location Address
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Address Line | 1901 S EUCLID AVE STE 3
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City | BAY CITY
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State | MI
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Zip | 48706-3491
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Country | US
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Telephone | 989-667-6460
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Fax | 989-667-6462
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Provider Business Mailing Address
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Address Line | 1901 S EUCLID AVE STE 3
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City | BAY CITY
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State | MI
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Zip | 48706-3491
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Country | US
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Telephone | 989-667-6460
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Fax | 989-667-6462
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. TIMOTHY SCOTT BELILL
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Credential | MPT
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Telephone | 989-752-7823
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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 | 5501008017
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License Number State | MI
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