Healthcare Provider Details

I. General information

NPI: 1851588859
Provider Name (Legal Business Name): WEST MICHIGAN REHAB PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 E BELTLINE AVE NE SUITE A
GRAND RAPIDS MI
49525-1097
US

IV. Provider business mailing address

PO BOX 838
ROCKFORD MI
49341-0838
US

V. Phone/Fax

Practice location:
  • Phone: 616-447-4090
  • Fax: 616-447-4098
Mailing address:
  • Phone: 616-447-4090
  • Fax: 616-447-4098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RAMIN RAHIMI
Title or Position: OWNER, MEDICAL DIRECTOR
Credential: D.O.
Phone: 616-447-4090