Healthcare Provider Details

I. General information

NPI: 1699619973
Provider Name (Legal Business Name): ENERGIZE WELLNESS & PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S UNION ST UNIT B
TRAVERSE CITY MI
49684-2665
US

IV. Provider business mailing address

2463 HARBOR REACH DR
TRAVERSE CITY MI
49686-8461
US

V. Phone/Fax

Practice location:
  • Phone: 231-883-2323
  • Fax:
Mailing address:
  • Phone: 231-883-2323
  • 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: CASSIDY KLEIN
Title or Position: MEMBER
Credential:
Phone: 231-883-2323