Provider Demographics
NPI:1114627775
Name:INSPIRE REHABILITATION AND WELLNESS LLC
Entity Type:Organization
Organization Name:INSPIRE REHABILITATION AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:LETNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:847-571-4313
Mailing Address - Street 1:4290 E TOMAHAWK DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-7502
Mailing Address - Country:US
Mailing Address - Phone:847-571-4313
Mailing Address - Fax:
Practice Address - Street 1:4290 E TOMAHAWK DR
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-7502
Practice Address - Country:US
Practice Address - Phone:847-571-4313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy