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General NPI Number Information
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NPI Number | 1477707743
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Entity Type | Organization
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Legal Business Name | MILESTONES AND MOBILITY CENTER, INC.
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 1414 W FAIR AVE SUITE 348
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City | MARQUETTE
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State | MI
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Zip | 49855-2675
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Country | US
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Telephone | 906-225-7960
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Fax | 906-225-7983
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Provider Business Mailing Address
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Address Line | 1414 W FAIR AVE SUITE 348
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City | MARQUETTE
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State | MI
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Zip | 49855-2675
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Country | US
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Telephone | 906-225-7960
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Fax | 906-225-7983
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN ANN PARKER
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Credential | PT
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Telephone | 906-225-7960
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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 | 5501003484
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License Number State | MI
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