Healthcare Provider Details

I. General information

NPI: 1982376661
Provider Name (Legal Business Name): HAWLEY INSTITUTE PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 PINE GROVE AVE STE 7
FORT GRATIOT MI
48059-4245
US

IV. Provider business mailing address

3900 PINE GROVE AVE STE 7
FORT GRATIOT MI
48059-4245
US

V. Phone/Fax

Practice location:
  • Phone: 810-824-3763
  • Fax: 810-264-4377
Mailing address:
  • Phone: 810-824-3763
  • Fax: 810-264-4377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: NATHAN SCOTT HAWLEY
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 810-300-2569