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General NPI Number Information
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NPI Number | 1922997857
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Entity Type | Individual
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Provider Name | MAGEN GROSSHANS
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Gender | Female
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 5968 PARK LAKE RD
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City | EAST LANSING
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State | MI
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Zip | 48823-9201
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Country | US
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Telephone | 517-339-1532
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Fax |
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Provider Business Mailing Address
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Address Line | 720 CHERRY ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1702
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Country | US
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Telephone | 517-899-3740
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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