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NPI Code Detail

MEDICARE: MRS. CARA C GRUBER MS PT

MEDICARE:  MRS. CARA C GRUBER  MS 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
1225100000XPhysical Therapist5501010402MI

General Provider Information

NPI Number : 1972560308
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARA C GRUBER MS PT
Provider Business Mailing Address
First Line : 603 W 10TH ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684
Country : US
Telephone Number : 231-342-6737
Fax Number :
Provider Business Practice Location Address
First Line : 4480 MT HOPE RD
Second Line : STE A
City : WILLIAMSBURG
State : MI
Zip : 49690
Country : US
Telephone Number : 231-938-2425
Fax Number : 231-938-2453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. CARA C GRUBER MS PT” Practice Location

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