Provider Demographics
NPI:1790123396
Name:TRANSCEND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:TRANSCEND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:QUINTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:734-219-2865
Mailing Address - Street 1:TRANSCEND PHYSICAL THERAPY
Mailing Address - Street 2:PO BOX 162
Mailing Address - City:BLISSFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49228-0162
Mailing Address - Country:US
Mailing Address - Phone:517-486-5278
Mailing Address - Fax:517-486-5298
Practice Address - Street 1:TRANSCEND PHYSICAL THERAPY
Practice Address - Street 2:116 S. LANE ST.
Practice Address - City:BLISSFIELD
Practice Address - State:MI
Practice Address - Zip Code:49228-1206
Practice Address - Country:US
Practice Address - Phone:517-486-5278
Practice Address - Fax:517-486-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN99640006Medicare PIN