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General NPI Number Information
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NPI Number | 1578364907
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Entity Type | Individual
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Provider Name | BRIDGET I INMAN LMT
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Gender | Female
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 5286 PLAINFIELD AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-1047
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Country | US
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Telephone | 606-224-8092
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Fax | 606-224-8092
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Provider Business Mailing Address
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Address Line | 18900 W KIMBALL RD
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City | PIERSON
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State | MI
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Zip | 49339-9605
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Country | US
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Telephone | 606-224-8092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501007752
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License Number State | MI
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