Healthcare Provider Details

I. General information

NPI: 1871404996
Provider Name (Legal Business Name): BRANDON ZINK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6105 W ST JOE HWY STE 211
LANSING MI
48917-4850
US

IV. Provider business mailing address

1537 NATALIE LN APT 207
ANN ARBOR MI
48105-2938
US

V. Phone/Fax

Practice location:
  • Phone: 888-619-9735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304749
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: