Provider Demographics
NPI:1023220878
Name:HIGHLAND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:HIGHLAND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:MUNDERLOH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-463-0345
Mailing Address - Street 1:7338 N ALGER RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1072
Mailing Address - Country:US
Mailing Address - Phone:989-463-0345
Mailing Address - Fax:989-466-5472
Practice Address - Street 1:7338 N ALGER RD
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1072
Practice Address - Country:US
Practice Address - Phone:989-463-0345
Practice Address - Fax:989-466-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP28950Medicare ID - Type UnspecifiedNONE