Provider Demographics
NPI:1710342829
Name:COUTURIER, MICHELLE R
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:COUTURIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5620
Mailing Address - Country:US
Mailing Address - Phone:989-450-3341
Mailing Address - Fax:989-778-1237
Practice Address - Street 1:4616 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3805
Practice Address - Country:US
Practice Address - Phone:899-355-1010
Practice Address - Fax:899-355-1011
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist