Healthcare Provider Details

I. General information

NPI: 1285265868
Provider Name (Legal Business Name): ANNA OCKASKIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18000 COVE ST STE 202
SPRING LAKE MI
49456-1383
US

IV. Provider business mailing address

891 MARYLAND AVE NE
GRAND RAPIDS MI
49505-6005
US

V. Phone/Fax

Practice location:
  • Phone: 616-847-1280
  • Fax: 616-847-1290
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304224
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: