MEDICARE: DR. LAURIE THERESA MONAHAN-HUGHES DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501018217	MI

General Provider Information

NPI Number	:	1346778974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE THERESA MONAHAN-HUGHES DPT

Provider Business Mailing Address
First Line	:	1234 E BROOMFIELD ST STE A3
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4491
Country	:	US
Telephone Number	:	989-773-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 E BROOMFIELD ST STE A3
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4491
Country	:	US
Telephone Number	:	989-773-1333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	07/21/2022

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