Organization
CENTRAL MICHIGAN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL SIAS (CREDENTIALING)
(989) 774-2597
Entity
Organization
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C70020
BCBSM
MI
Enumeration date
02/04/2014
Last updated
02/04/2014
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