MEDICARE: BRIDGET I INMAN LMT

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
1	225700000X	Massage Therapist	7501007752	MI

General Provider Information

NPI Number	:	1578364907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET I INMAN LMT

Provider Business Mailing Address
First Line	:	18900 W KIMBALL RD
Second Line	:
City	:	PIERSON
State	:	MI
Zip	:	49339-9605
Country	:	US
Telephone Number	:	606-224-8092
Fax Number	:

Provider Business Practice Location Address
First Line	:	5286 PLAINFIELD AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-1047
Country	:	US
Telephone Number	:	606-224-8092
Fax Number	:	606-224-8092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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Directions to “ BRIDGET I INMAN LMT” Practice Location

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