Healthcare Provider Details

I. General information

NPI: 1932692464
Provider Name (Legal Business Name): APRIL PELFREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2018
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 RAYBROOK ST SE
GRAND RAPIDS MI
49546-7717
US

IV. Provider business mailing address

420 ALABAMA AVE NW APT 107
GRAND RAPIDS MI
49504-5708
US

V. Phone/Fax

Practice location:
  • Phone: 616-333-2721
  • Fax:
Mailing address:
  • Phone: 269-873-8592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502005620
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501302508
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: