Evergreen Physical Therapy Limited Partnership

NPI #1558374280 in Gladwin, Michigan

Provider Information

NPI Number: 1558374280
Entity Type: Organization
Organization Name: Evergreen Physical Therapy Limited Partnership
Subpart: Yes (part of a larger organization)
Parent Organization: EVERGREEN PHYSICAL THERAPY LIMITED PARTNERSHIP
Primary Specialty: Physical Therapist
Enumeration Date: Aug 14, 2006
Last Updated: Nov 10, 2008

Practice Location

Address: 1206 N STATE ST
City: Gladwin
State: Michigan
ZIP Code: 48624-1246
Phone: (989) 246-2311

Authorized Official

Name: JANNA P. KING, JD
Title: VP, AUTHORIZED OFFICIAL
Phone: (713) 297-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X
Physical Therapist	225100000X	Primary

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