Healthcare Provider Details

I. General information

NPI: 1437273877
Provider Name (Legal Business Name): NORTHWOODS REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MINNEAPOLIS AVE SUITE C
GLADSTONE MI
49837
US

IV. Provider business mailing address

2001 MINNEAPOLIS AVE. SUITE C
GLADSTONE MI
49837
US

V. Phone/Fax

Practice location:
  • Phone: 906-428-3085
  • Fax:
Mailing address:
  • Phone: 906-428-3085
  • Fax: 906-428-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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