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Organization
LEVEL 11 PHYSICAL THERAPY
Active
Organization
LEVEL 11 PHYSICAL THERAPY
Active
Other names
Level 11
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 420-2512
Entity
Organization
Contact information
Practice address
10483 DIXIE HWY, HOLLY, MI 48442-9210
(810) 771-7686
(810) 771-7685
Mailing address
10483 DIXIE HWY, HOLLY, MI 48442-9210
(810) 771-7686
(810) 771-7685
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/29/2009
Last updated
09/26/2023
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