Provider Demographics
NPI:1003823246
Name:COSGROVE, PATRICK ALLAN (PT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:ALLAN
Last Name:COSGROVE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8872 PROFESSIONAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8481
Mailing Address - Country:US
Mailing Address - Phone:231-876-0010
Mailing Address - Fax:231-876-0241
Practice Address - Street 1:2147 PROFESSIONAL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735
Practice Address - Country:US
Practice Address - Phone:989-732-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55013003622251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic