| NPI | 1992067037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER H. GENNRICH President/Administrator 989-401-3566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501003744) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MI 5501003744) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501003744) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |