MEDICARE: MICHELLE VAN OSS PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2797	NE
2	225100000X	Physical Therapist	004443	IA
3	225100000X	Physical Therapist	5501017260	MI

General Provider Information

NPI Number	:	1023407749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE VAN OSS PT, DPT

Provider Business Mailing Address
First Line	:	854 WASHINGTON AVE STE 200
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-7143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	854 WASHINGTON AVE STE 200
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-7143
Country	:	US
Telephone Number	:	616-392-9430
Fax Number	:	616-392-5257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2015
Last Update Date	:	12/11/2023

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