Organization
LEVEL 11 PHYSICAL THERAPY
Active
Other names
Level 11
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 420-2512
Entity
Organization
Contact information
Practice address
10483 DIXIE HWY, HOLLY, MI 48442-9210
(810) 771-7686
(810) 771-7685
Mailing address
10483 DIXIE HWY, HOLLY, MI 48442-9210
(810) 771-7686
(810) 771-7685
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2009
Last updated
09/26/2023
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