Individual
BLESILDA BOOC TIBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
90 N MICHIGAN AVE, COLDWATER, MI 49036-1527
(517) 278-6454
Mailing address
90 N MICHIGAN AVE, COLDWATER, MI 49036-1527
(517) 278-6454
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007681
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501007681
BOARD OF PHYSICAL THERAPY
MI
Enumeration date
04/11/2019
Last updated
04/11/2019
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