Provider Demographics
NPI:1508010620
Name:CENTRAL MICHIGAN HAND THERAPY LLC
Entity Type:Organization
Organization Name:CENTRAL MICHIGAN HAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:989-289-3755
Mailing Address - Street 1:1012 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-6100
Mailing Address - Country:US
Mailing Address - Phone:989-289-3755
Mailing Address - Fax:
Practice Address - Street 1:2890 HEALTH PARKWAY
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-6931
Practice Address - Country:US
Practice Address - Phone:989-289-3755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1334879225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty