FUNCTIONAL INNOVATIVE THERAPY, LLC (NPI# 1093727802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093727802 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL INNOVATIVE THERAPY, LLC |
| Other Organization Name | FIT THERAPY |
| Practice Address |
3035 Hoag Ave Ne Grand Rapids MI 49525-9632 |
| Practice Telephone | 6163659394 |
| Practice Fax Number | 6163659394 |
| Mailing Telephone | 6163659394 |
| Mailing Fax Number | 6163659394 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-04-22 |
| Authorized Official Name | DR. TREY JOSEPH KUBIZNA (MEMBER) |
| Authorized Official Telephone | 6163659394 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5501012424 | MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FIT Therapy | Doing Business As Name - Organization |
| Street Address |
3035 HOAG AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-9632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265411565 | Trey J Kubizna | Physical Therapist | 3035 Hoag Ave Ne, Grand Rapids, MI 49525-9632 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| 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 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on FUNCTIONAL INNOVATIVE THERAPY, LLC.
| 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.