Healthcare Provider Details

I. General information

NPI: 1841370319
Provider Name (Legal Business Name): RACHEL ELIZABETH DAVIES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 EAST BELTLINE LANE NE
GRAND RAPIDS MI
49525-9432
US

IV. Provider business mailing address

2816 EAST BELTLINE LANE NE
GRAND RAPIDS MI
49525-9432
US

V. Phone/Fax

Practice location:
  • Phone: 616-361-1210
  • Fax: 616-361-8662
Mailing address:
  • Phone: 616-361-1210
  • Fax: 616-361-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011332
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: