Neisha Ann Dickman, P.T.

Individual provider Active NPI Physical Therapist · Harbor Beach, MI

NPI 1245388917 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1245388917
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501008477 (MI)
Practice address
305 S Klug Rd
Harbor Beach, MI 48441-8713
Phone
(989) 479-0452
Fax
(989) 479-3603
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501008477MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501008477 MI Yes

Addresses

Primary practice location

305 S Klug Rd
Harbor Beach, MI 48441-8713

Mailing address

305 S Klug Rd
Harbor Beach, MI 48441-8713
Phone (989) 479-0452

Other identifiers

IdentifierTypeStateIssuer
0C25703OtherMIBLUE CROSS PROVIDER

Other providers in Harbor Beach, MI

All providers in Harbor Beach, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.