MEDICARE: MITCHELL ZIGLER PT

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	5501009489	MI

General Provider Information

NPI Number	:	1386051118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL ZIGLER PT

Provider Business Mailing Address
First Line	:	106 E MAIN ST
Second Line	:
City	:	SPRING ARBOR
State	:	MI
Zip	:	49283-9701
Country	:	US
Telephone Number	:	517-750-6324
Fax Number	:	517-750-6625

Provider Business Practice Location Address
First Line	:	106 E MAIN ST
Second Line	:
City	:	SPRING ARBOR
State	:	MI
Zip	:	49283-9701
Country	:	US
Telephone Number	:	517-750-6324
Fax Number	:	517-750-6625

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

Provider Enumeration Date	:	07/14/2014
Last Update Date	:	01/22/2016

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