Provider Demographics
NPI:1184903684
Name:UNGER, MICHELLE RENEE TYRRELL (MS, PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE TYRRELL
Last Name:UNGER
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 LOS GATOS SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5310
Mailing Address - Country:US
Mailing Address - Phone:408-402-3228
Mailing Address - Fax:408-608-1970
Practice Address - Street 1:333 LOS GATOS SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5310
Practice Address - Country:US
Practice Address - Phone:408-402-3228
Practice Address - Fax:408-608-1970
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA27383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist