Most Relevant Information
Provider Data
| NPI Number: | 1003317207 |
| Provider Name: | LAURA DIVER MSPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/22/2018 |
| Last Updated: | 02/22/2018 |
Provider Practice Location
6227 FRANKFORT HWY STE B
BENZONIA
MI
496168633
Practice Location Phone/Fax
| Phone: | 2318820083 |
| Fax: |
Provider Mailing Location
6227 FRANKFORT HWY STE B
BENZONIA
MI
496168633
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |