MEDICARE: CHRISTINE LOUISE CUMMINGS 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	5501004284	MI

General Provider Information

NPI Number	:	1871766972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE LOUISE CUMMINGS PT

Provider Business Mailing Address
First Line	:	878 S ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2740
Country	:	US
Telephone Number	:	248-601-9207
Fax Number	:

Provider Business Practice Location Address
First Line	:	21550 HARRINGTON ST
Second Line	:	SUITE D
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-2362
Country	:	US
Telephone Number	:	586-783-7590
Fax Number	:

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

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/09/2008

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