Alexis Alyse McCaul

Individual provider Active NPI Physical Therapy Assistant · Shepherd, MI

NPI 1487201190 · NPPES record last updated Aug 19, 2019

Key facts

NPI
1487201190
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5502005860 (MI)
Practice address
7113 S Whiteville Rd
Shepherd, MI 48883-8513
Phone
(989) 560-6290
NPI assigned
Aug 19, 2019
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)
No

State licenses

LicenseStateTypeSpecialty
5502005860MIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502005860 MI Yes

Addresses

Primary practice location

7113 S Whiteville Rd
Shepherd, MI 48883-8513

Mailing address

7113 S Whiteville Rd
Shepherd, MI 48883-8513
Phone (989) 560-6290

Other providers in Shepherd, MI

All providers in Shepherd, MI · Physical Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.