Mastercare Physical Therapy and Wellness Center LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501300653 Issued in MI

Legal business name

MASTERCARE PHYSICAL THERAPY AND WELLNESS CENTER LLC

Practice address

6909 Highland Rd
Suite B
Waterford, MI 48327-1648

Phone

(248) 674-5277

Fax

(248) 674-5871

NPI assigned

Sep 19, 2012

Last updated

Sep 19, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Susan Johnson, PT

Title

Owner

Phone

(248) 494-3873

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1073863874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 HIGHLAND RD",
            "address_2": "SUITE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271648",
            "telephone_number": "248-674-5277",
            "fax_number": "248-674-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 HIGHLAND RD",
            "address_2": "SUITE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271648",
            "telephone_number": "248-674-5277",
            "fax_number": "248-674-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTERCARE PHYSICAL THERAPY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-494-3873",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501300653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Eileen Marttila, BS, CADCM, CCSM
• Marvin D. Siegel, M.D., P.C.
• Marvin S. Taylor DDS PC (Dr Taylors Family Dental Center)
• Mary Ann Harchick DDS PC
• Mary Lou Spitz MD
• Emily A Mastick, LLMSW
• Jeby Mathew, PHARMD
• Cheryl Mathis
• Matthew E Heins DC PC
• Colin Darryl Matthews

• Physical Therapist in Waterford, MI
• Providers in Waterford, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.