Provider Demographics
NPI:1487156899
Name:MCMAHON, EILEEN MARY (PT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARY
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-7264
Mailing Address - Country:US
Mailing Address - Phone:989-832-4220
Mailing Address - Fax:989-832-4207
Practice Address - Street 1:304 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-7264
Practice Address - Country:US
Practice Address - Phone:989-832-4220
Practice Address - Fax:989-832-4207
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist