Provider Demographics
NPI:1225229560
Name:PHYSICAL THERAPY SERVICES OF LANSING, LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SERVICES OF LANSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:269-372-8483
Mailing Address - Street 1:6563 W MAIN ST
Mailing Address - Street 2:SUITE: LOWER LEVEL
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4051
Mailing Address - Country:US
Mailing Address - Phone:269-372-8483
Mailing Address - Fax:269-372-6113
Practice Address - Street 1:3937 PATIENT CARE WAY
Practice Address - Street 2:SUITE 105
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4287
Practice Address - Country:US
Practice Address - Phone:269-372-8483
Practice Address - Fax:269-372-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P50180Medicare PIN