Provider Demographics
NPI:1154667822
Name:RENUE 005 ANN ARBOR LLC
Entity Type:Organization
Organization Name:RENUE 005 ANN ARBOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAPISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-401-5282
Mailing Address - Street 1:2100 S MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6432
Mailing Address - Country:US
Mailing Address - Phone:989-401-5282
Mailing Address - Fax:
Practice Address - Street 1:2100 S MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6432
Practice Address - Country:US
Practice Address - Phone:989-401-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty