Healthcare Provider Details

I. General information

NPI: 1619524220
Provider Name (Legal Business Name): LOVELL HAND & ORTHOPEDIC CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 E PARIS AVE SE STE 210
GRAND RAPIDS MI
49546-6190
US

IV. Provider business mailing address

2155 E PARIS AVE SE STE 210
GRAND RAPIDS MI
49546-6190
US

V. Phone/Fax

Practice location:
  • Phone: 616-655-1570
  • Fax: 616-655-1571
Mailing address:
  • Phone: 616-655-1570
  • Fax: 616-655-1571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: LISA LOVELL
Title or Position: DIRECTOR OF FINANCES AND MARKETING
Credential: RN, BSN
Phone: 616-581-4443