Organization
FUNCTIONAL DIMENSIONS LLC
Active
Other names
Superior Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CHARLES GORECKI (OWNER)
(231) 649-2015
Entity
Organization
Contact information
Practice address
3899 W. FRONT ST UNIT 3, TRAVERSE CITY, MI 49684
(231) 649-2015
(231) 421-8447
Mailing address
3899 W. FRONT ST UNIT 3, TRAVERSE CITY, MI 49684
(231) 649-2015
(231) 421-8447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501014611
MI
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
02/20/2015
Last updated
12/15/2020
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