Basic Information
Provider Information
NPI: 1760654099
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNER
FirstName: JAMES
MiddleName: GILFORD
NamePrefix: DR.
NameSuffix:  
Credential: MPT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 802 13TH ST
Address2:  
City: RAWLINS
State: WY
PostalCode: 823016521
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2900 CHARLEVOIX DR SE STE 200
Address2:  
City: GRAND RAPIDS
State: MI
PostalCode: 495467086
CountryCode: US
TelephoneNumber: 8006341077
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/26/2008
LastUpdateDate: 03/26/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1161489TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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