Renue 018 Tawas, Llc | |
540 W Lake St Ste 3, Tawas City, MI 48763-5101 | |
(989) 984-6075 | |
(989) 305-6038 |
Full Name | Renue 018 Tawas, Llc |
---|---|
Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 540 W Lake St Ste 3, Tawas City, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790452043 | NPI | - | NPPES |
1790452043 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Shaun M Sullivan |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1144221342 PECOS PAC ID: 9436111499 Enrollment ID: I20050205000049 |
Provider Name | Roland M Leonora |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1447470505 PECOS PAC ID: 3779683156 Enrollment ID: I20070713000670 |
Provider Name | Mladen N Svorinic |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1164664470 PECOS PAC ID: 2769532142 Enrollment ID: I20090604000660 |
Provider Name | Alicia M Heading |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912224742 PECOS PAC ID: 7113057993 Enrollment ID: I20100607000020 |
Provider Name | Casey Joseph Sowinski |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1114233186 PECOS PAC ID: 9537355185 Enrollment ID: I20101123000041 |
Provider Name | Kimberly Barcalow |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1225326622 PECOS PAC ID: 5890965164 Enrollment ID: I20110823000863 |
Provider Name | Nicole Marie Judson |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1497098594 PECOS PAC ID: 8921247735 Enrollment ID: I20130626000541 |
Provider Name | Melinda E Bierlein |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1760787360 PECOS PAC ID: 0143456228 Enrollment ID: I20131120002032 |
Provider Name | Michelle Couturier |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1710342829 PECOS PAC ID: 6901109339 Enrollment ID: I20160119002311 |
Provider Name | Shane Omara |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1356799266 PECOS PAC ID: 9739472192 Enrollment ID: I20160721002527 |
Provider Name | Stephen Zingg |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1376071233 PECOS PAC ID: 5991073140 Enrollment ID: I20170613001201 |
Provider Name | Jesse Siwek |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1396223178 PECOS PAC ID: 1658620141 Enrollment ID: I20180816000972 |
Provider Name | Camille Gabriella-joanne Lutz |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1962983957 PECOS PAC ID: 4587916580 Enrollment ID: I20181002002151 |
Provider Name | Russell Thomas Leonard |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1538634456 PECOS PAC ID: 0244575165 Enrollment ID: I20181221000708 |
Provider Name | Abigail Lynn Boensch |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1073079919 PECOS PAC ID: 9931449683 Enrollment ID: I20190318000368 |
Provider Name | Crystal Parker |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720581416 PECOS PAC ID: 5395175194 Enrollment ID: I20200418000197 |
Provider Name | Courtney Siwek |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1245714039 PECOS PAC ID: 8820401631 Enrollment ID: I20210114002529 |
Provider Name | Kate Alison Maurer |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720485311 PECOS PAC ID: 7618376997 Enrollment ID: I20210519001852 |
Provider Name | Jacob Young |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1699152645 PECOS PAC ID: 9133525777 Enrollment ID: I20210908001282 |
Provider Name | Megan Marie Leser |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1780352187 PECOS PAC ID: 0042618423 Enrollment ID: I20211015000845 |
Provider Name | Breanne Bell |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1871069021 PECOS PAC ID: 0143628537 Enrollment ID: I20211015001383 |
Provider Name | Celeste M Vanwert |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881195709 PECOS PAC ID: 4385037159 Enrollment ID: I20220201000145 |
Provider Name | Paige N Rybak |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1437621661 PECOS PAC ID: 1759777493 Enrollment ID: I20220406002081 |
Provider Name | Michelle Barancik |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1730682915 PECOS PAC ID: 4688053010 Enrollment ID: I20220615001900 |
Provider Name | Kaitlyn Ouillette |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1215595293 PECOS PAC ID: 1850770074 Enrollment ID: I20220617002545 |
Provider Name | Kristen Rice |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1346745700 PECOS PAC ID: 9830565977 Enrollment ID: I20221014001691 |
Provider Name | Gina Grantham |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1194329896 PECOS PAC ID: 4587033824 Enrollment ID: I20221208002649 |
Provider Name | Jill Mccoy |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1437673852 PECOS PAC ID: 0648636936 Enrollment ID: I20230511000561 |
Provider Name | Brandon Robert Worden |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1376193532 PECOS PAC ID: 8628422334 Enrollment ID: I20230929000581 |
Provider Name | Kathryn Elizabeth Polisano |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1598542698 PECOS PAC ID: 2860847449 Enrollment ID: I20231017002949 |
Provider Name | Jennifer Lynne Look |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326549023 PECOS PAC ID: 9739531930 Enrollment ID: I20240123002592 |
Provider Name | Brandon Svorinic |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1013766195 PECOS PAC ID: 9931641057 Enrollment ID: I20240604004231 |
Provider Name | Meghan J Dewaele |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1174289334 PECOS PAC ID: 8820488281 Enrollment ID: I20240921000477 |
Provider Name | Malarry R Wenger |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1346063252 PECOS PAC ID: 1759815442 Enrollment ID: I20241118002739 |
Mailing Address | Practice Location Address |
---|---|
Renue 018 Tawas, Llc 804 N Water St, Bay City, MI 48708-5620 Ph: (989) 450-3341 | Renue 018 Tawas, Llc 540 W Lake St Ste 3, Tawas City, MI 48763-5101 Ph: (989) 984-6075 |