| NPI | 1568649986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN HERTEL Physical Therapist/Member 231-799-8883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501004375) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201001131) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2011-02-01 |