FUEL PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC


Address: 1139 Houseman Ave Ne, Grand Rapids, MI 49503-1229
Phone: 8103475219

FUEL PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC (NPI# 1063980373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063980373
Entity Type Organization
Organization Name FUEL PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC
Practice Address 1139 Houseman Ave Ne
Grand Rapids
MI 49503-1229
Practice Telephone 8103475219
Practice Fax Number 6162594226
Mailing Telephone 8103475219
Enumeration Date 2018-11-05
Last Update Date 2018-11-05
Authorized Official Name ERIC SCOTT BROADWORTH (OWNER/PHYSICAL THERAPIST)
Authorized Official Telephone 8103475219
Authorized Official Credential DPT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2251X0800X Physical Therapist
Specialization: Orthopedic
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 261QP2000X Clinic/Center
Specialization: Physical Therapy
Ambulatory Health Care Facilities

Office Location

Street Address 1139 HOUSEMAN AVE NE
City GRAND RAPIDS
State MI
Zip Code 49503-1229

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NPI Name Taxonomy Address Enumeration
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1730707282 Adriana Molina-schmuker Counselor 901 Eastern Avenue Ne, Grand Rapids, MI 49503 2020-07-10
1477176949 Kimberly Buskirk Specialist 1131 Ionia Ava Nw, Grand Rapids, MI 49503 2020-05-19
1124647805 Jared Host Speech-Language Pathologist Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 2020-04-13
1265061378 Heather Gladfelter Student in an Organized Health Care Education/Training Program 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 2020-04-02
1194368647 Amy Jo Arends Nurse Practitioner 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 2019-10-28
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
1295387256 Althea Ziolkowski Licensed Practical Nurse Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 2019-07-10
1790340719 Heather Anne Fox Occupational Therapist Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 2019-05-06
1184182883 April L Kaiserlian Social Worker 983 Spaulding Ave Ne, Ada, MI 49503 2019-03-12
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Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821362278 Primary Rehab Center LLC Clinic/Center 2055 28th St Se Ste 7, Grand Rapids, MI 49508 2012-03-02
1417183971 Agility Health Rehabilitation LLC Clinic/Center 607 Dewey Ave Nw, Suite 300, Grand Rapids, MI 49504-7335 2009-06-10
1386739738 Physiotherapy Associates Inc Clinic/Center 515 Michigan St Ne, Grand Rapids, MI 49503-5721 2006-10-03
1346719234 Dynamic Movement and Recovery Clinic/Center 4950 Plainfield Ave Ne Ste A, Grand Rapids, MI 49525-1059 2018-11-20
1902288863 Center for Physical Rehabilitation and Therapy Lp Clinic/Center 5060 Cascade Rd Se, Suite A, Grand Rapids, MI 49546-3808 2015-06-26
1598169682 Good Life Therapy LLC Clinic/Center 1331 Lake Dr Se, Suite 105, Grand Rapids, MI 49506-1674 2014-10-17
1811313612 Alans Physical Therapy of Grand Rapids Clinic/Center 111 Golf Course Rd, Suite 2, Grand Rapids, MN 55744-3526 2014-03-17
1295098945 In Home Therapy of Grand Rapids, LLC Clinic/Center 2433 Valentine Blvd Ne, Grand Rapids, MI 49525-3070 2012-06-18
1508130147 Patti Kampa Physical Therapy Clinic/Center 15 Ne 5th St, Grand Rapids, MN 55744-2760 2012-02-29
1871728816 Hulst Jepsen Physical Therapy Clinic/Center 2120 43rd St Se, Suite 100, Grand Rapids, MI 49508-3772 2009-05-20
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Competitor

Search similar providers

City GRAND RAPIDS
Zip Code 49503

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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