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General NPI Number Information
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NPI Number | 1003620444
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Entity Type | Organization
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Legal Business Name | ENVIROMOD ERGONOMIC SOLUTIONS LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1246 S POSEYVILLE RD
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City | MIDLAND
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State | MI
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Zip | 48640-7907
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Country | US
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Telephone | 989-233-2320
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 S POSEYVILLE RD
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City | MIDLAND
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State | MI
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Zip | 48640-7907
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Country | US
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Telephone | 989-233-2320
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | KYLE KAUFMANN
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Credential | OTRL
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Telephone | 989-233-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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