Healthcare Provider Details

I. General information

NPI: 1548740871
Provider Name (Legal Business Name): RENUE 012 ESSEXVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 09/02/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2618 CENTER AVE
BAY CITY MI
48708-6300
US

IV. Provider business mailing address

804 N WATER ST
BAY CITY MI
48708-5620
US

V. Phone/Fax

Practice location:
  • Phone: 989-892-4557
  • Fax: 989-892-4686
Mailing address:
  • Phone: 989-450-3341
  • Fax: 989-778-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY KLAPISH
Title or Position: CEO
Credential:
Phone: 989-450-3341