Organization
GREAT LAKES THERAPY HOUSE CALLS PC
Active
Other names
GREAT LAKES PHYSICAL THERAPY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A HARVEY PT (ADMINISTRATOR)
(231) 941-8100
Entity
Organization
Contact information
Practice address
5123 N ROYAL DR, TRAVERSE CITY, MI 49684-9201
(231) 941-8100
(231) 941-8812
Mailing address
1650 BARLOW ST, TRAVERSE CITY, MI 49686-4721
(231) 941-8100
(231) 922-0382
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650B8
BCBS OF MI
MI
01
—
670B8
BCBS MI
MI
Enumeration date
05/22/2007
Last updated
02/19/2021
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