| |
4990 N Van Dyke, Kinde, MI 48445-0004 | |
(989) 874-4600 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 4990 N Van Dyke, Kinde, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356525984 | NPI | - | NPPES |
0N97200 | Other | MI | MEDICARE PROVIDER NUMBER |
650G610300 | Other | MI | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 5501007571 (Michigan) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 4, Kinde, MI 48445-0004 Ph: (989) 874-4600 | 4990 N Van Dyke, Kinde, MI 48445-0004 Ph: (989) 874-4600 |