| NPI | 1174311138 |
|---|---|
| Doing Business As | PURE FORM PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JULIA L OTWELL Physical Therapist 231-252-5773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |