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Organization
PHYSICAL THERAPY ONE, P.C.
Active
Organization
PHYSICAL THERAPY ONE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BRUCE WALTERS M.S, P.T (OWNER, PHYSICAL THERAPIST)
(269) 323-4300
Entity
Organization
Contact information
Practice address
1423 W CENTRE AVE, PORTAGE, MI 49024-5351
(269) 323-4300
(269) 323-4449
Mailing address
1423 W CENTRE AVE, PORTAGE, MI 49024-5351
(269) 323-4300
(269) 323-4449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501004752
MI
225100000X
Physical Therapist
Primary
5501008230
MI
225100000X
Physical Therapist
5501008430
MI
225100000X
Physical Therapist
5501009829
MI
225100000X
Physical Therapist
5501010759
MI
225100000X
Physical Therapist
5501011041
MI
225100000X
Physical Therapist
5501011392
MI
225100000X
Physical Therapist
5501012189
MI
225100000X
Physical Therapist
5501013485
MI
225100000X
Physical Therapist
5501013900
MI
225100000X
Physical Therapist
5501015684
MI
225200000X
Physical Therapy Assistant
5502000788
MI
225200000X
Physical Therapy Assistant
5502002365
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30702
BLUE CROSS
MI
01
—
64-32017
IBA/PHP
MI
01
—
P93923
BLUE CARE NETWORK
MI
Enumeration date
10/05/2005
Last updated
06/28/2012
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