Organization
GREAT LAKES PHYSICAL THERAPY-NORTH MUSKEGON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY A EATON MS, PT, FAFS (OWNER)
(231) 744-0077
Entity
Organization
Contact information
Practice address
2045 HOLTON RD, NORTH MUSKEGON, MI 49445-1535
(231) 744-0077
(231) 744-0030
Mailing address
2045 HOLTON RD, NORTH MUSKEGON, MI 49445-1535
(231) 744-0077
(231) 744-0030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011276
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30609
BCBS
MI
05
—
4717630
—
MI
Enumeration date
03/27/2013
Last updated
03/27/2013
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