Healthcare Provider Details

I. General information

NPI: 1942398821
Provider Name (Legal Business Name): BODY MECHANIX PHYSICAL THERAPY OF ESCANABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SOUTH LINCOLN ROAD SUITE B
ESCANABA MI
49829
US

IV. Provider business mailing address

49253 STATE HIGHWAY M26
HANCOCK MI
49930-9331
US

V. Phone/Fax

Practice location:
  • Phone: 906-370-5355
  • Fax: 906-789-1500
Mailing address:
  • Phone: 906-370-5355
  • Fax: 906-337-3869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. CLARENCE KELLY HRABINSKY
Title or Position: OWNER
Credential: P.T.
Phone: 906-370-5355