Organization
TRAILSIDE HARVEST HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET MCCORMICK MPT, ND (SOLE PROPRIETOR)
(248) 651-8691
Entity
Organization
Contact information
Practice address
1930 W GUNN RD, ROCHESTER, MI 48306-1565
(248) 651-8691
Mailing address
1930 W GUNN RD, ROCHESTER, MI 48306-1565
(248) 651-8691
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501004273
MI
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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