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NPI Code Detail

MEDICARE: GREAT LAKES PELVIC REHAB, PLLC

MEDICARE: GREAT LAKES PELVIC REHAB, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist

General Provider Information

NPI Number : 1518809813
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT LAKES PELVIC REHAB, PLLC
Provider Business Mailing Address
First Line : 404 S PROSPECT ST
Second Line :
City : SAINT JOHNS
State : MI
Zip : 48879-1770
Country : US
Telephone Number : 616-202-6444
Fax Number :
Provider Business Practice Location Address
First Line : 330 W LAKE LANSING RD
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-8527
Country : US
Telephone Number : 616-202-6444
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST, OWNER
Name : ALAINA KATE VINCE
Credential : PT, DPT
Telephone Number : 616-202-6444
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “GREAT LAKES PELVIC REHAB, PLLC ” Practice Location

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