Healthcare Provider Details

I. General information

NPI: 1932307022
Provider Name (Legal Business Name): NORTHWOODS REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 US HIGHWAY 2/41
BARK RIVER MI
49807-9791
US

IV. Provider business mailing address

2845 US HIGHWAY 2/41
BARK RIVER MI
49807-9791
US

V. Phone/Fax

Practice location:
  • Phone: 906-466-2090
  • Fax:
Mailing address:
  • Phone: 906-466-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number5501011535
License Number StateMI

VIII. Authorized Official

Name: DAN HOWES
Title or Position: OWNER
Credential: PT
Phone: 906-428-3085