Provider Demographics
NPI:1316813140
Name:MLS EXERCISE SERVICES LLC
Entity type:Organization
Organization Name:MLS EXERCISE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LAMBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ACSM-EP
Authorized Official - Phone:231-510-0325
Mailing Address - Street 1:3650 DONNA LN
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8153
Mailing Address - Country:US
Mailing Address - Phone:231-510-0325
Mailing Address - Fax:
Practice Address - Street 1:3650 DONNA LN
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8153
Practice Address - Country:US
Practice Address - Phone:231-510-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty