Provider Demographics
NPI:1467662510
Name:CAUSIN, MICHAEL ECARMA (MPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ECARMA
Last Name:CAUSIN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5139 SPINNING WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-4229
Mailing Address - Country:US
Mailing Address - Phone:810-695-7857
Mailing Address - Fax:
Practice Address - Street 1:2500 N ELMS RD
Practice Address - Street 2:SUITE A
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-9426
Practice Address - Country:US
Practice Address - Phone:810-342-5550
Practice Address - Fax:810-342-5589
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist