Provider Demographics
NPI:1124888417
Name:REACTIVE PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:REACTIVE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BEIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-347-2189
Mailing Address - Street 1:3693 PICKEREL LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-9326
Mailing Address - Country:US
Mailing Address - Phone:231-347-2189
Mailing Address - Fax:
Practice Address - Street 1:446 E MITCHELL ST STE 3
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-4604
Practice Address - Country:US
Practice Address - Phone:231-622-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty