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General NPI Number Information
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NPI Number | 1407930951
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Entity Type | Individual
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Provider Name | CATHLEEN MARIE NAGLE PT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31000 LAHSER RD SUITE 1
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-4847
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Country | US
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Telephone | 248-290-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 WOODLAND AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-3083
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Country | US
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Telephone | 248-288-4932
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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 | 5501003852
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License Number State | MI
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