| Gaurav Mitra, | |
|
1769 S Cedar St, Imlay City, MI 48444-1300 | |
| (810) 724-0421 | |
| (810) 721-0423 |
| Full Name | Gaurav Mitra |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1769 S Cedar St, Imlay City, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104078443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501013172 (Michigan) | Primary |
| Provider Name | Michigan Luna Care Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1003448994 PECOS PAC ID: 9032549217 Enrollment ID: O20200501000804 |
| Mailing Address | Practice Location Address |
|---|---|
| Gaurav Mitra, 1769 S Cedar St, Imlay City, MI 48444-1300 Ph: (810) 724-0421 | Gaurav Mitra, 1769 S Cedar St, Imlay City, MI 48444-1300 Ph: (810) 724-0421 |
Laura A Ellis, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1769 S Cedar, Imlay City, MI 48444 Phone: 810-724-0421 Fax: 810-721-0423 | |
Thibodeau Physical Therapy Limited Partnership Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1808 S Cedar St, Imlay City, MI 48444 Phone: 810-721-0421 Fax: 810-721-0423 | |
Mrs. Rachelle Leigh Baier, MPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1769 S Cedar St, Imlay City, MI 48444 Phone: 810-724-0421 Fax: 810-721-0423 | |
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1808 S Cedar St, Imlay City, MI 48444 Phone: 810-724-0421 | |
Bonnie Maas, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1769 S Cedar St, Imlay City, MI 48444 Phone: 810-724-0421 Fax: 810-721-0423 | |
Vinita D Shah, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 Newark Rd, Suite 200, Imlay City, MI 48444 Phone: 810-721-8700 Fax: 810-721-8715 |