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General NPI Number Information
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NPI Number | 1851870299
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Entity Type | Individual
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Provider Name | NICHOLAS THOMAS MCBRIDE DPT
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Gender | Male
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6500 BYRON CENTER AVE SW STE 202
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City | BYRON CENTER
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State | MI
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Zip | 49315-9083
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Country | US
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Telephone | 616-249-0750
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Fax | 616-249-0794
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Provider Business Mailing Address
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Address Line | 2224 VANSINGEL LAKE DR SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-8091
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Country | US
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Telephone | 616-822-7890
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5501016868
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501016868
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License Number State | MI
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