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General NPI Number Information
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NPI Number | 1467719252
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Entity Type | Organization
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Legal Business Name | MICHIGAN PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 124 SOUTH MORENCI STREET
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City | MIO
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State | MI
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Zip | 48647-1032
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Country | US
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Telephone | 989-390-3718
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Fax | 989-826-6860
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Provider Business Mailing Address
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Address Line | PO BOX 1032
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City | MIO
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State | MI
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Zip | 48647-1032
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Country | US
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Telephone | 989-826-6830
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Fax | 989-826-6860
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Authorized Official
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Title or Position | OFFICER
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Name | MR. JERRY PARKER
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Credential |
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Telephone | 989-390-3718
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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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