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General NPI Number Information
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NPI Number | 1164233599
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Entity Type | Organization
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Legal Business Name | 616 PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 3669 PLAINFIELD AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-2477
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Country | US
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Telephone | 616-202-1872
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Fax |
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Provider Business Mailing Address
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Address Line | 3669 PLAINFIELD AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-2477
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Country | US
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Telephone | 616-202-1872
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Fax |
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Authorized Official
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Title or Position | OWNER, PT
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Name | KARI CHAPPELL
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Credential | PT
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Telephone | 616-745-7153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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