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General NPI Number Information
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NPI Number | 1790452043
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Entity Type | Organization
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Legal Business Name | RENUE 018 TAWAS, LLC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 540 W LAKE ST STE 3
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City | TAWAS CITY
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State | MI
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Zip | 48763-5101
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Country | US
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Telephone | 989-984-6075
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Fax | 989-305-6038
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Provider Business Mailing Address
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Address Line | 804 N WATER ST
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City | BAY CITY
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State | MI
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Zip | 48708-5620
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Country | US
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Telephone | 989-450-3341
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Fax | 989-778-1237
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Authorized Official
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Title or Position | CEO
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Name | ANTHONY KLAPISH
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Credential |
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Telephone | 989-450-3341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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