Organization
SPORT TRACK PHYSICAL THERAPY AND HUMAN PERFORMANCE
Active
Organization
SPORT TRACK PHYSICAL THERAPY AND HUMAN PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN PRICE DPT (OWNER)
(269) 362-5242
Entity
Organization
Contact information
Practice address
115 E MAIN ST, NILES, MI 49120-2224
(269) 362-5242
(269) 912-5922
Mailing address
3248 CHABOT RD, BENTON HARBOR, MI 49022-9526
(269) 362-5242
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679055917
TYPE 1 NPI
MI
Enumeration date
08/03/2022
Last updated
08/26/2022
Update your record
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