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Organization
IN HOME REHAB OF DICKINSON COUNTY
Active
Organization
IN HOME REHAB OF DICKINSON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL L CARLSON (OWNER)
(906) 563-8920
Entity
Organization
Contact information
Practice address
N19748 TIMM'S LAKE ROAD, SUITE 1, NIAGARA, WI 54151
(906) 563-8920
Mailing address
W3101 RIDGECREST RD., VULCAN, MI 49892
(906) 563-8920
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003532
MI
225X00000X
Occupational Therapist
5201002404
MI
Other
Enumeration date
03/27/2007
Last updated
10/11/2007
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