Great Lakes Physical Therapy-north Muskegon, Llc | |
2045 Holton Rd, North Muskegon, MI 49445-1535 | |
(231) 744-0077 | |
(231) 744-0030 |
Full Name | Great Lakes Physical Therapy-north Muskegon, Llc |
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Type | Facility |
Speciality | Physical Therapist |
Location | 2045 Holton Rd, North Muskegon, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265774368 | NPI | - | NPPES |
30609 | Other | MI | BCBS |
4717630 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 5501011276 (Michigan) | Primary |
Provider Name | Jeffrey A Eaton |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1033204870 PECOS PAC ID: 2264597509 Enrollment ID: I20090413000178 |
Provider Name | Lisa M Radosa |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1851486211 PECOS PAC ID: 0244389658 Enrollment ID: I20090519000229 |
Provider Name | Randall R Prince |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1891898763 PECOS PAC ID: 0345383907 Enrollment ID: I20100204000120 |
Provider Name | Robin J Wilcox |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1982958427 PECOS PAC ID: 2163677535 Enrollment ID: I20130311000197 |
Mailing Address | Practice Location Address |
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Great Lakes Physical Therapy-north Muskegon, Llc 2045 Holton Rd, North Muskegon, MI 49445-1535 Ph: (231) 744-0077 | Great Lakes Physical Therapy-north Muskegon, Llc 2045 Holton Rd, North Muskegon, MI 49445-1535 Ph: (231) 744-0077 |
Mr. Krupal R Amin, RPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1519 E River Rd, Suite # A, North Muskegon, MI 49445 Phone: 231-744-9800 Fax: 231-744-9833 | |
Ms. Jane M Wright, PT, MHS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2045 Holton Rd, North Muskegon, MI 49445 Phone: 231-744-0077 Fax: 231-744-0030 |