Provider Demographics
NPI:1972519676
Name:FEBEY, RICHARD W (PT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:W
Last Name:FEBEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-1415
Mailing Address - Country:US
Mailing Address - Phone:989-348-5220
Mailing Address - Fax:989-348-2015
Practice Address - Street 1:709 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1415
Practice Address - Country:US
Practice Address - Phone:989-348-5220
Practice Address - Fax:989-348-2015
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B05701Medicare ID - Type UnspecifiedPHYSICAL THERAPY