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General NPI Number Information
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NPI Number | 1780424853
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Entity Type | Individual
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Provider Name | RILEIGH ELIZABETH GRACE EDING PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 16760 LINCOLN ST
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City | GRAND HAVEN
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State | MI
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Zip | 49417-8864
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Country | US
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Telephone | 616-935-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 725 CRESCENT ST NE APT 2
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-3501
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Country | US
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Telephone | 616-212-6872
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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