Healthcare Provider Details

I. General information

NPI: 1285360305
Provider Name (Legal Business Name): I-FITNESS REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 NEWARK CIR
GRAND BLANC MI
48439-2510
US

IV. Provider business mailing address

4390 NEWARK CIR
GRAND BLANC MI
48439-2510
US

V. Phone/Fax

Practice location:
  • Phone: 248-885-7402
  • Fax:
Mailing address:
  • Phone: 248-885-7402
  • Fax:

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 Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BHARGAV PATEL
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 248-885-7402