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Organization
MOUNTAIN TOWN REHAB, INC
Active
Organization
MOUNTAIN TOWN REHAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK THOMAS STANSBERRY PT (OWNER)
(989) 779-2920
Entity
Organization
Contact information
Practice address
1106 W HIGH ST, MT PLEASANT, MI 48858-2242
(989) 779-2920
(989) 772-9424
Mailing address
1106 W HIGH ST, MT PLEASANT, MI 48858-2242
(989) 779-2920
(989) 772-9424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005383
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650C700040
BLUE CROSS BLUE SHEILD
MI
Enumeration date
05/22/2007
Last updated
06/21/2008
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