Most Relevant Information
Provider Data
| NPI Number: | 1003474768 |
| Provider Name: | MAGAN RIVERA LPTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 5502003868 |
Most Important Dates
| Enumeration Date: | 05/29/2019 |
| Last Updated: | 05/29/2019 |
Provider Practice Location
212 W CAROLINE ST
BELLEVUE
MI
490211336
Practice Location Phone/Fax
| Phone: | 2699247174 |
| Fax: |
Provider Mailing Location
212 W CAROLINE ST
BELLEVUE
MI
490211336
Provider Mailing Phone/Fax
| Phone: | 2699247174 |
| Fax: |