Healthcare Provider Details

I. General information

NPI: 1295887594
Provider Name (Legal Business Name): ACCELERATED MOBILITY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 EASTERN SKY DR
TRAVERSE CITY MI
49684-7351
US

IV. Provider business mailing address

PO BOX 632656
CINCINNATI OH
45263-2656
US

V. Phone/Fax

Practice location:
  • Phone: 231-932-9014
  • Fax: 231-932-9034
Mailing address:
  • Phone: 702-818-5000
  • Fax: 702-818-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC DOUGLASS
Title or Position: CCO
Credential: PT
Phone: 941-870-4401