Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 5501013616 | MI |
N | 2251P0200X | Physical Therapist - Pediatrics | 5501013616 | MI |
NPI | 1043465149 |
---|---|
Provider Name | Miss Cibele Maziliauskas Granito |
First Address | Muskegon, MI 49444-8796 |
Second Address | Muskegon, MI 49444-8796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 23/03/2011 |