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Organization
MEDINFOPLATFORMA
Active
Organization
MEDINFOPLATFORMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYKOLA MATSYUK MD,DPT (PRESIDENT)
(410) 565-2813
Entity
Organization
Contact information
Practice address
47 N WEBER RD, MUSKEGON, MI 49445-2153
(410) 565-2813
Mailing address
29660 CITY CENTER DR APT 4, WARREN, MI 48093-2413
(410) 565-2813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710470380
—
MI
Enumeration date
04/08/2020
Last updated
04/08/2020
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