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General NPI Number Information
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NPI Number | 1366110959
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY ASSOICATES, INC.
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 120 S DEXTER ST STE 400
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City | IONIA
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State | MI
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Zip | 48846-1548
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Country | US
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Telephone | 717-972-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4714 GETTYSBURG RD
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4325
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Country | US
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Telephone | 717-972-1100
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHAEL TARVIN
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Credential |
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Telephone | 717-972-1100
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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