Organization
IN HOME REHAB NORTHERN MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA KRUZYNSKI (OWNER)
(989) 733-5123
Entity
Organization
Contact information
Practice address
6559 MILLERSBURG RD, MILLERSBURG, MI 49759-9785
(989) 733-5123
Mailing address
6559 MILLERSBURG RD, MILLERSBURG, MI 49759-9785
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650G110070
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
07/22/2006
Last updated
02/01/2013
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