Organization
NORTHSHORE REHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN LYNN MEYER DO (PRESIDENT S CORPORATION)
(231) 947-5071
Entity
Organization
Contact information
Practice address
901 W FRONT ST, SUITE B, TRAVERSE CITY, MI 49684-2374
(231) 947-5071
(231) 947-5094
Mailing address
901 W FRONT ST, SUITE B, TRAVERSE CITY, MI 49684-2374
(231) 947-5071
(231) 947-5094
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
5101013561
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2552810134
BCBS PIN #
MI
05
—
4673607
—
MI
Enumeration date
10/20/2006
Last updated
02/18/2010
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