Healthcare Provider Details

I. General information

NPI: 1790990968
Provider Name (Legal Business Name): MOBILITYPLUS REHABILITATION, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MAIN STREET
HAWLEY MN
56549
US

IV. Provider business mailing address

520 MAIN STREET
HAWLEY MN
56549
US

V. Phone/Fax

Practice location:
  • Phone: 218-483-1500
  • Fax: 218-483-1501
Mailing address:
  • Phone: 218-483-1500
  • Fax: 218-483-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RYAN R LORENZ
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 701-678-2244