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General NPI Number Information
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NPI Number | 1619062817
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Entity Type | Organization
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Legal Business Name | CENTRAL MICHIGAN UNIVERSITY
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 1101 HEALTH PROFESSIONS BUILDING
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City | MT PLEASANT
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State | MI
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Zip | 48859-0001
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Country | US
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Telephone | 989-774-3904
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Fax | 989-774-1891
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Provider Business Mailing Address
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Address Line | 1101 HEALTH PROFESSIONS BUILDING
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City | MT PLEASANT
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State | MI
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Zip | 48859-0001
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Country | US
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Telephone | 989-774-3904
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Fax | 989-774-1891
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | KATE HODGKINS
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Credential |
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Telephone | 989-774-6624
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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 | MI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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