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General NPI Number Information
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NPI Number | 1245804699
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Entity Type | Organization
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Legal Business Name | SZYMECKO RECREATIONAL THERAPY, LLC
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 419 N MAIN ST
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City | WEBBERVILLE
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State | MI
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Zip | 48892-9707
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Country | US
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Telephone | 734-330-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 419 N MAIN ST
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City | WEBBERVILLE
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State | MI
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Zip | 48892-9707
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Country | US
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Telephone | 734-330-6272
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Fax |
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Authorized Official
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Title or Position | OWNER, RECREATIONAL THERAPIST
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Name | MR. MATTHEW R HARGIS
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Credential | CTRS
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Telephone | 734-330-6272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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