Basic Information
| Provider Information | |||||||||
| NPI: | 1720013915 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POPE | ||||||||
| FirstName: | VONDA | ||||||||
| MiddleName: | JOGCE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PTAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 54 EDISON CT | ||||||||
| Address2: | |||||||||
| City: | COLDWATER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172782719 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5500 ARMSTRONG ROAD | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699665600 | ||||||||
| FaxNumber: | 2699665481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 06001623A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.