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General NPI Number Information
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NPI Number | 1629953591
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Entity Type | Individual
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Provider Name | ROBERT CHARLES FITZPATRICK
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Gender | Male
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 113 W BROADWAY ST. SUITE 110, ROOM 3
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858
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Country | US
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Telephone | 989-289-0929
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Fax |
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Provider Business Mailing Address
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Address Line | 1844 W LUDINGTON DR
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City | FARWELL
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State | MI
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Zip | 48622-9742
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Country | US
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Telephone | 989-339-7669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501011841
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License Number State | MI
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