Provider Demographics
NPI:1922293810
Name:WEST CENTRAL REHABILITATION , LLC
Entity Type:Organization
Organization Name:WEST CENTRAL REHABILITATION , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-861-2131
Mailing Address - Street 1:71 BEVIER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHELBY
Mailing Address - State:MI
Mailing Address - Zip Code:49455-1239
Mailing Address - Country:US
Mailing Address - Phone:231-861-2131
Mailing Address - Fax:231-861-4801
Practice Address - Street 1:71 BEVIER ST
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBY
Practice Address - State:MI
Practice Address - Zip Code:49455-1239
Practice Address - Country:US
Practice Address - Phone:231-861-2131
Practice Address - Fax:231-861-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty