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General NPI Number Information
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NPI Number | 1396257135
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Entity Type | Organization
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Legal Business Name | METAMORA PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 3562 S LAPEER RD STE F
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City | METAMORA
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State | MI
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Zip | 48455-8998
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Country | US
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Telephone | 810-212-1277
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Fax |
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Provider Business Mailing Address
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Address Line | 3562 S LAPEER RD STE F
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City | METAMORA
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State | MI
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Zip | 48455-8998
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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 | DPT
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Name | HEIDI IRWIN
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Credential |
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Telephone | 810-964-3125
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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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