Provider Demographics
NPI:1144407339
Name:REHAB MOVEMENT WELLNESS, LLC
Entity Type:Organization
Organization Name:REHAB MOVEMENT WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-573-0891
Mailing Address - Street 1:10500 BUCK
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-9772
Mailing Address - Country:US
Mailing Address - Phone:989-573-0891
Mailing Address - Fax:888-972-5590
Practice Address - Street 1:4600 FASHION SQUARE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2676
Practice Address - Country:US
Practice Address - Phone:989-573-0891
Practice Address - Fax:888-972-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MI5501003959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty