Organization
JAMES RANDOLPH TILTON
Active
Other names
Ithaca Physical Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RANDOLPH TILTON JR. P.T. (PHYSICAL THERAPIST, OWNER)
(989) 875-2266
Entity
Organization
Contact information
Practice address
203 DILTS RD, ITHACA, MI 48847-9475
(989) 875-2266
(989) 875-2225
Mailing address
875 E HARRISON RD, ALMA, MI 48801-9343
(989) 463-1590
(989) 875-2266
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607647900
OFFICE OF WORKER'S COMP.
MI
Enumeration date
07/13/2006
Last updated
06/02/2014
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