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General NPI Number Information
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NPI Number | 1689204703
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ERGONOMICS LLC
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 1754 CENTRAL PARK DR APT H
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City | OKEMOS
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State | MI
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Zip | 48864-1258
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Country | US
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Telephone | 517-349-4268
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Fax | 517-349-4298
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Provider Business Mailing Address
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Address Line | 228 CHURCH HILL DOWNS BLVD
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City | WILLIAMSTON
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State | MI
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Zip | 48895-9053
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Country | US
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Telephone | 517-927-7220
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERYL A GOODREAU
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Credential | OTR/L
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Telephone | 517-927-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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