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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