Provider Demographics
NPI:1629181920
Name:MIDLAND PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:MIDLAND PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LSLES-TRUAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-832-6485
Mailing Address - Street 1:5319 N SAGINAW RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7501
Mailing Address - Country:US
Mailing Address - Phone:989-832-6485
Mailing Address - Fax:989-832-6487
Practice Address - Street 1:5319 N SAGINAW RD
Practice Address - Street 2:SUITE A
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7501
Practice Address - Country:US
Practice Address - Phone:989-832-6485
Practice Address - Fax:989-832-6487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008926261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy