| NPI | 1508848318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL DENEFF President 616-840-8317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 01686) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: MI 01686) |
| 2251H1200X Physical Therapist, Hand (Licence: MI 01686) | |
| 2251N0400X Physical Therapist, Neurology (Licence: MI 01686) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: MI 01686) | |
| 2251S0007X Physical Therapist, Sports (Licence: MI 01686) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MI 01686) | |
| 225X00000X Occupational Therapist (Licence: MI 5201002959) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-08-03 |