Healthcare Provider Details

I. General information

NPI: 1548379571
Provider Name (Legal Business Name): REHABILITATION MEDICINE ASSOCIATES,PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 EAGLE PARK DR NE SUITE 108
GRAND RAPIDS MI
49525-4570
US

IV. Provider business mailing address

3350 EAGLE PARK DR NE SUITE 108
GRAND RAPIDS MI
49525-4570
US

V. Phone/Fax

Practice location:
  • Phone: 616-458-1088
  • Fax: 616-458-7809
Mailing address:
  • Phone: 616-458-1088
  • Fax: 616-458-7809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: JANET GIERSCH
Title or Position: ADM MGR
Credential:
Phone: 616-458-1088