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General NPI Number Information
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NPI Number | 1396255634
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Entity Type | Organization
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Legal Business Name | ASCENT PT NORTON SHORES LLC
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Dates
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Enumeration Date | 09/30/2017
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 433 SEMINOLE RD STE 102
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City | NORTON SHORES
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State | MI
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Zip | 49444-3743
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Country | US
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Telephone | 231-690-6198
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Fax |
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Provider Business Mailing Address
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Address Line | 433 SEMINOLE RD STE 102
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City | NORTON SHORES
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State | MI
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Zip | 49444-3743
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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 | VP
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Name | LYNN JUSTUSSON
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Credential |
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Telephone | 248-743-0396
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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 |
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License Number State |
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