| Health In Motion Rehab Services | |
|
2530 Lineville Rd Ste 1 Green Bay WI 54313-8861 | |
| (920) 857-3126 | |
| (920) 273-6008 |
| Full Name | Health In Motion Rehab Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2530 Lineville Rd Ste 1, Green Bay, Wisconsin |
| Authorized Official Name and Position | Ryan Michael Tachick (OWNER) |
| Authorized Official Contact | 9206606081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health In Motion Rehab Services 3446 Jersey Ln Suamico WI 54313-3624 Ph: (920) 660-6081 | Health In Motion Rehab Services 2530 Lineville Rd Ste 1 Green Bay WI 54313-8861 Ph: (920) 857-3126 |
| NPI Number | 1932822004 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 10/30/2023 |
| Medicare PECOS PAC ID | 4284003104 |
|---|---|
| Medicare Enrollment ID | O20221215000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932822004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Susan Harris-peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982841862 PECOS PAC ID: 6800944489 Enrollment ID: I20090508000508 |
| Provider Name | Suzanne J Eickert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629034509 PECOS PAC ID: 0840280798 Enrollment ID: I20150508001430 |
| Provider Name | Brian Crenshaw |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639464290 PECOS PAC ID: 0143441055 Enrollment ID: I20220419002100 |
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