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Lacey Physical Therapy Center Incorporated
Specialist in Mattawan, Michigan
NPI 1164649497

Lacey Physical Therapy Center Incorporated is a Specialist based in Mattawan, MI. Lacey Physical Therapy Center Incorporated practices in Mattawan, MI. The NPI Number for Lacey Physical Therapy Center Incorporated is 1164649497 and holds a License No. 5501010346 (Michigan).

The current practice location address for Lacey Physical Therapy Center Incorporated is 23211 Red Arrow Hwy, Mattawan, MI and can be reached out via phone at 269-668-5930 and via fax at 269-668-5921.

Location: 23211 Red Arrow Hwy, Mattawan, MI, 49071-9701
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164649497
Provider Name
Lacey Physical Therapy Center Incorporated
Credential
Provider Entity Type
Organization
Address
23211 Red Arrow Hwy, Mattawan, MI, 49071-9701
Phone Number
269-668-5930
Fax Number
269-668-5921
Provider Enumeration Date
04/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
155764 01 MI GREAT LAKES UNITED HEALTH
6430129 01 MI IBA
650H000020 01 MI BCBS MI
7993476 01 MI AETNA
institution
Provider Business Practice Location Address Details
Address
23211 Red Arrow Hwy
City
Mattawan
State
Michigan
Zip
49071-9701
Phone Number
269-668-5930
Fax Number
269-668-5921
person
Provider Business Mailing Address Details
Address
23211 Red Arrow Hwy
City
Mattawan
State
Michigan
Zip
49071-9701
Phone Number
269-668-5930
Fax Number
269-668-5921
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
5501010346 (Michigan)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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