Provider Demographics
NPI:1851172977
Name:MINDSET PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:MINDSET PHYSICAL THERAPY LLC
Other - Org Name:MINDSET PHYSICAL THERAPY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-944-8439
Mailing Address - Street 1:3600 VETERANS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4582
Mailing Address - Country:US
Mailing Address - Phone:231-463-0754
Mailing Address - Fax:231-252-4634
Practice Address - Street 1:3600 VETERANS DR STE 2
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4582
Practice Address - Country:US
Practice Address - Phone:231-463-0754
Practice Address - Fax:231-252-4634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty