Individual
ELIZABETH MODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1400 W ICE LAKE RD, IRON RIVER, MI 49935-9526
(906) 265-9123
(906) 265-4335
Mailing address
1246 STROMBERG RD, IRON RIVER, MI 49935-8989
(206) 300-5290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13700-24
WI
225100000X
Physical Therapist
Primary
5501017844
MI
225100000X
Physical Therapist
PT60647103
WA
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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