Organization
MUNGER PHYSICAL THERAPY, PLC
Active
Organization
MUNGER PHYSICAL THERAPY, PLC
Active
Other names
Munger Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARKUS MICHAEL MUNGER PT (OWNER/ ADMINISTRATOR)
(810) 385-7405
Entity
Organization
Contact information
Practice address
4351 24TH AVE, SUITE 1, FORT GRATIOT, MI 48059-4506
(810) 385-7405
(810) 385-7420
Mailing address
4351 24TH AVE, SUITE 1, FORT GRATIOT, MI 48059-4506
(810) 385-7405
(810) 385-7420
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501004051
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65-0-G4-1223-0
BLUE CROSS AND BLUS SHIELD OF MICHIGAN
MI
Enumeration date
05/27/2008
Last updated
08/04/2008
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