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2609 Charlevoix Ave, Petoskey, MI 49770 | |
(989) 858-5107 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 2609 Charlevoix Ave, Petoskey, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083456834 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Dean E Tahtinen |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1942202619 PECOS PAC ID: 8921998980 Enrollment ID: I20040405001040 |
Provider Name | Thomas W Kirkby |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1942464870 PECOS PAC ID: 6103993902 Enrollment ID: I20080919000518 |
Mailing Address | Practice Location Address |
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2609 Charlevoix Ave, Petoskey, MI 49770 Ph: (989) 858-5107 | 2609 Charlevoix Ave, Petoskey, MI 49770 Ph: (989) 858-5107 |