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NPI Code Detail

MEDICARE: RENUE 012 ESSEXVILLE, LLC

MEDICARE: RENUE 012 ESSEXVILLE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2261QP2000XPhysical Therapy Clinic/Center
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1548740871
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENUE 012 ESSEXVILLE, LLC
Provider Business Mailing Address
First Line : 804 N WATER ST
Second Line :
City : BAY CITY
State : MI
Zip : 48708-5620
Country : US
Telephone Number : 989-450-3341
Fax Number : 989-778-1237
Provider Business Practice Location Address
First Line : 2618 CENTER AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-6300
Country : US
Telephone Number : 989-892-4557
Fax Number : 989-892-4686
Authorized Official
Title or Position : CEO
Name : ANTHONY KLAPISH
Credential :
Telephone Number : 989-450-3341
Provider Enumeration Date : 08/16/2018
Last Update Date : 09/02/2025

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