Provider Demographics
NPI:1023117876
Name:MUSCLE & SPINE REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:MUSCLE & SPINE REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ESSEX
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT, MS, DPT, OCS
Authorized Official - Phone:269-979-3000
Mailing Address - Street 1:2545 CAPITAL AVE SW STE 140
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7103
Mailing Address - Country:US
Mailing Address - Phone:269-979-3000
Mailing Address - Fax:269-979-9770
Practice Address - Street 1:2545 CAPITAL AVE SW STE 140
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7103
Practice Address - Country:US
Practice Address - Phone:269-979-3000
Practice Address - Fax:269-979-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004323-PT/MI261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N18350Medicare ID - Type Unspecified
MI6162790001Medicare NSC