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NPI Code Detail

MEDICARE: MARY E OURSLER P.T.

MEDICARE:   MARY E OURSLER  P.T.
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
1225100000XPhysical Therapist05002832AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000112014OTHERINANTHEM ID

General Provider Information

NPI Number : 1598732026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E OURSLER P.T.
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1992 E STOP 13 RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-6267
Country : US
Telephone Number : 317-808-0230
Fax Number : 317-808-0231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 01/08/2025

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Directions to “ MARY E OURSLER P.T.” Practice Location

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