Organization
NORTHERN MICHIGAN SPORTS MEDICINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY M SMITH PT (ADMINISTRATOR)
(231) 347-9300
Entity
Organization
Contact information
Practice address
4048 CEDAR BLUFF DR, SUITE 2, PETOSKEY, MI 49770-8895
(231) 347-9300
(231) 347-1613
Mailing address
4048 CEDAR BLUFF DR, SUITE 2, PETOSKEY, MI 49770-8895
(231) 347-9300
(231) 347-1613
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135445900
DEPARTMENT OF LABOR
MI
01
—
30617
FEDERAL BCBS
MI
01
—
900002332
PRIORITY HEALTH
MI
Enumeration date
04/13/2006
Last updated
07/17/2025
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