Organization
ACTIVE RECOVERY PHYSICAL THERAPY & SPORTS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA NOWKA (OWNER, AT, PTA)
(989) 996-1098
Entity
Organization
Contact information
Practice address
250 S LAKE ST STE E, EAST JORDAN, MI 49727-9376
(231) 222-2121
Mailing address
250 S LAKE ST STE E, EAST JORDAN, MI 49727-9376
(231) 222-2121
(231) 222-2009
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
07/27/2020
Last updated
10/15/2020
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