Organization
ENDURANCE REHABILITATION & ATHLETICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM EDWIN HOMOLKA MPT (OWNER)
(616) 307-9950
Entity
Organization
Contact information
Practice address
6440 FULTON ST E, SUITE 150, ADA, MI 49301-8449
(616) 307-9950
Mailing address
6440 FULTON ST E, SUITE 150, ADA, MI 49301-8449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501012622
MI
2251S0007X
Sports Physical Therapist
5501012622
MI
2251X0800X
Orthopedic Physical Therapist
Primary
5501012622
MI
Other
Enumeration date
10/27/2016
Last updated
12/12/2016
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