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General NPI Number Information
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NPI Number | 1538211925
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Entity Type | Organization
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Legal Business Name | ELK RAPIDS PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 128 AMES ST
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City | ELK RAPIDS
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State | MI
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Zip | 49629-9739
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Country | US
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Telephone | 231-264-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 128 AMES ST
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City | ELK RAPIDS
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State | MI
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Zip | 49629-9739
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Country | US
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Telephone | 231-264-6682
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RHONDA BAKER LAMMERS
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Credential | P.T.
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Telephone | 231-264-6682
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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 | 5501003682
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License Number State | MI
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