Healthcare Provider Details

I. General information

NPI: 1700542875
Provider Name (Legal Business Name): FIT FOR YOU PHYSICAL THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 W MICHIGAN AVE
JACKSON MI
49202-4011
US

IV. Provider business mailing address

5800 FOLKS RD
HORTON MI
49246-9632
US

V. Phone/Fax

Practice location:
  • Phone: 517-745-7685
  • Fax:
Mailing address:
  • Phone: 517-745-7685
  • Fax:

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: CHELSEA PETRAKOVITZ
Title or Position: OWNER/DOCTOR OF PHYSICAL THERAPY
Credential: DPT
Phone: 517-745-7685