| Organization Name: | EVERGREEN PHYSICAL THERAPY LIMITED PARTNERSHIP |
| NPI Number: | 1558374280 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANNA P. KING (VP, AUTHORIZED OFFICIAL) |
| Mailing Address: | 1206 N State St Gladwin |
| State: | MI US |
| Postal Code: | 486241246 |
| Phone Number: | 9892462311 |
| Fax Number: | 9892462315 |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 11/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |