Provider Demographics
NPI:1386051118
Name:ZIGLER, MITCHELL (PT)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:ZIGLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9701
Mailing Address - Country:US
Mailing Address - Phone:517-750-6324
Mailing Address - Fax:517-750-6625
Practice Address - Street 1:106 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9701
Practice Address - Country:US
Practice Address - Phone:517-750-6324
Practice Address - Fax:517-750-6625
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist