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General NPI Number Information
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NPI Number | 1508895806
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY SERVICES OF WEST MICHIGAN LLC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 6563 W MAIN ST SUITE LOWER LEVEL
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City | KALAMAZOO
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State | MI
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Zip | 49009-4051
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Country | US
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Telephone | 269-488-3320
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Fax | 269-372-6113
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Provider Business Mailing Address
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Address Line | 6563 W MAIN ST SUITE LOWER LEVEL
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City | KALAMAZOO
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State | MI
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Zip | 49009-4051
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Country | US
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Telephone | 269-488-3320
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Fax | 269-372-6113
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Authorized Official
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Title or Position | MEMBER
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Name | MS. KATHY LOU CARRIER
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Credential | PT
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Telephone | 269-488-3320
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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 |
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License Number State |
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