Provider Demographics
NPI:1982807723
Name:MOBILITYPLUS REHABILITATION, LTD
Entity type:Organization
Organization Name:MOBILITYPLUS REHABILITATION, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:701-678-2244
Mailing Address - Street 1:110 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ENDERLIN
Mailing Address - State:ND
Mailing Address - Zip Code:58027-1129
Mailing Address - Country:US
Mailing Address - Phone:701-437-3782
Mailing Address - Fax:
Practice Address - Street 1:110 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ENDERLIN
Practice Address - State:ND
Practice Address - Zip Code:58027-1129
Practice Address - Country:US
Practice Address - Phone:701-437-3782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND51106Medicaid