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Individual

AME RICA SANTIAGO PALACPAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1650 BARLOW ST, TRAVERSE CITY, MI 49686-4721
(231) 941-3100
Mailing address
3786 ZIMMERMAN RD, TRAVERSE CITY, MI 49685-9001
(916) 606-6998

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013367
MI

Other

Enumeration date
11/04/2013
Last updated
07/12/2016
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