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Individual

CAROLINE THERESE O'BRIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
901 E TINKHAM AVE, LUDINGTON, MI 49431-1536
(231) 843-2676
(231) 843-2209
Mailing address
901 E TINKHAM AVE, LUDINGTON, MI 49431-1536
(231) 843-2676
(231) 843-2209

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003980
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E31033
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/19/2007
Last updated
08/27/2019
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