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General NPI Number Information
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NPI Number | 1376771287
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Entity Type | Organization
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Legal Business Name | MARQUETTE REHABILITATION & SPORTS MEDICINE CENTER
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 1455 W FAIR AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2654
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Country | US
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Telephone | 906-226-0574
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Fax | 888-347-1135
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Provider Business Mailing Address
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Address Line | 1455 W FAIR AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2654
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Country | US
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Telephone | 906-226-0574
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Fax | 888-347-1135
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. KIPLIN M HARTMAN
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Credential | DPT
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Telephone | 906-362-0013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501013363
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License Number State | MI
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