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General NPI Number Information
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NPI Number | 1912764127
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Entity Type | Organization
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Legal Business Name | BMOR LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 322 N LINCOLN RD
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City | ESCANABA
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State | MI
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Zip | 49829-1305
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Country | US
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Telephone | 906-553-7094
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Fax | 906-212-2046
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Provider Business Mailing Address
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Address Line | 3 HARBOR POINT LN
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City | GLADSTONE
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State | MI
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Zip | 49837-2771
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Country | US
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Telephone | 906-280-2995
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAYNE MARIE SZUKALOWSKI
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Credential |
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Telephone | 906-280-2995
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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 |
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