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General NPI Number Information
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NPI Number | 1891289336
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Entity Type | Individual
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Provider Name | WILLA V PRIN PT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 600 SE 4TH ST
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City | CLARE
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State | MI
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Zip | 48617-9201
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Country | US
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Telephone | 989-386-7723
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 SOMERSET CT
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City | MT PLEASANT
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State | MI
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Zip | 48858-4498
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Country | US
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Telephone | 989-400-9268
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501007639
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License Number State | MI
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