Healthcare Provider Details

I. General information

NPI: 1891247235
Provider Name (Legal Business Name): ALISON YUNKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 CHARLEVOIX DR SE SUITE 200
GRAND RAPIDS MI
49546-7085
US

IV. Provider business mailing address

1065 SHANGRILA DR
CINCINNATI OH
45230-4132
US

V. Phone/Fax

Practice location:
  • Phone: 616-975-5092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10261
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: