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General NPI Number Information
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NPI Number | 1528247921
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Entity Type | Organization
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Legal Business Name | STANDISH REHABILITATION CENTER INC
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 529 S MAIN ST SUITE G
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City | STANDISH
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State | MI
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Zip | 48658-9539
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Country | US
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Telephone | 989-846-0937
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1158
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City | STANDISH
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State | MI
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Zip | 48658-1158
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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 | OFFICE MGR
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Name | JILLIAN CHRISTIAN
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Credential |
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Telephone | 989-846-0937
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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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