| NPI | 1770684623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE THERESE O'BRIEN Member 231-843-2676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 935864) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-07-10 |