1982376661 NPI number — HAWLEY INSTITUTE PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982376661 NPI number — HAWLEY INSTITUTE PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAWLEY INSTITUTE PHYSICAL THERAPY & SPORTS PERFORMANCE, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982376661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3900 PINE GROVE AVE STE 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT GRATIOT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48059-4245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-824-3763
Provider Business Mailing Address Fax Number:
810-264-4377

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3900 PINE GROVE AVE STE 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT GRATIOT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48059-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-824-3763
Provider Business Practice Location Address Fax Number:
810-264-4377
Provider Enumeration Date:
10/01/2021

Additional Information

Authorized Official

Authorized Official Last Name:
HAWLEY
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
810-300-2569

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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