Provider Demographics
NPI:1235406471
Name:SAGINAW PT AND WELLNESS LLC
Entity Type:Organization
Organization Name:SAGINAW PT AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:989-249-7848
Mailing Address - Street 1:5061 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3709
Mailing Address - Country:US
Mailing Address - Phone:989-249-7848
Mailing Address - Fax:989-249-5363
Practice Address - Street 1:5061 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3709
Practice Address - Country:US
Practice Address - Phone:989-249-7848
Practice Address - Fax:989-249-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty