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Organization
KOVACEK PETERSON MANAGEMENT LLC
Active
Organization
KOVACEK PETERSON MANAGEMENT LLC
Active
Other names
Longterm Care Rehab Mangement Service LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PETER KOVACEK (PHYSICAL THERAPIST)
(586) 774-5774
Entity
Organization
Contact information
Practice address
12 KINGSLEY CT, FRANKENMUTH, MI 48734-1270
(989) 793-2856
Mailing address
12 KINGSLEY CT, FRANKENMUTH, MI 48734-1270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009515
MI
225X00000X
Occupational Therapist
5201000937
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650G312140
BLUE CROSS BLUE SHIELD MI
MI
01
—
DD5657
MEDICARE RAILROAD
MI
Enumeration date
08/01/2006
Last updated
08/02/2011
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