Organization
CENTRAL MICHIGAN REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANISH BONDALE PT (CLINIC DIRECTOR/PT)
(989) 772-0258
Entity
Organization
Contact information
Practice address
1500 W. HIGH STREET, MT. PLEASANT, MI 48858
(989) 772-0258
(989) 953-4603
Mailing address
1500 W. HIGH STREET, MT. PLEASANT, MI 48858
(989) 772-0258
(989) 953-4603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009360
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00710460
BLUE CROSS
MI
01
—
30069
BCBSM
—
05
—
404983397
—
MI
05
—
4877G07
—
MI
Enumeration date
09/27/2006
Last updated
03/19/2010
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