Healthcare Provider Details

I. General information

NPI: 1174756001
Provider Name (Legal Business Name): JEFFREY C PASCHALL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 COMMERCE DR STE B
ALLENDALE MI
49401-8200
US

IV. Provider business mailing address

11775 RESTFUL WAY
ALLENDALE MI
49401-7445
US

V. Phone/Fax

Practice location:
  • Phone: 616-895-4770
  • Fax:
Mailing address:
  • Phone: 931-980-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501303408
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT32184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: