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General NPI Number Information
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NPI Number | 1821148529
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Entity Type | Organization
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Legal Business Name | UP REHAB SERVICES LLC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 505 N HOOPER ST
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City | KINGSFORD
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State | MI
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Zip | 49802-5406
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Country | US
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Telephone | 906-776-9003
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Fax | 906-776-9063
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Provider Business Mailing Address
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Address Line | 555 COUNTY ROAD HQ
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City | MARQUETTE
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State | MI
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Zip | 49855-8855
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Country | US
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Telephone | 906-225-5570
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Fax | 906-225-5572
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Authorized Official
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Title or Position | COO
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Name | MR. RUSSELL TODD TRIPP
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Credential |
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Telephone | 906-225-5570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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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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