=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831040450
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVON VAN RENSBURG DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2026
-----------------------------------------------------
Last Update Date | 02/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5536 RESEARCH DR
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48188-2978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-895-1901
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43000 WILLIS CT
-----------------------------------------------------
City | BELLEVILLE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48111-9144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-665-5606
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5501304324
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------