Andrew Funsch, DPT

Individual provider Active NPI Physical Therapist · Charlevoix, MI

NPI 1982105169 · NPPES record last updated Feb 23, 2018

Key facts

NPI
1982105169
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501018205 (MI)
Practice address
14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone
(231) 547-8630
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
No

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
5501018205MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501018205 MI Yes

Addresses

Primary practice location

14700 Lake Shore Dr
Charlevoix, MI 49720-1931

Mailing address

14700 Lake Shore Dr
Charlevoix, MI 49720-1931

Other providers in Charlevoix, MI

All providers in Charlevoix, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.