MEDICARE: LEIGHANN KAY DEVRIES

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	225200000X	Physical Therapy Assistant	5502002269	MI

General Provider Information

NPI Number	:	1164360004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGHANN KAY DEVRIES

Provider Business Mailing Address
First Line	:	341 CLEVELAND ST W
Second Line	:
City	:	COOPERSVILLE
State	:	MI
Zip	:	49404-9673
Country	:	US
Telephone Number	:	616-862-9267
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 JEFFREY ST
Second Line	:
City	:	CEDAR SPRINGS
State	:	MI
Zip	:	49319-9572
Country	:	US
Telephone Number	:	616-696-0170
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ LEIGHANN KAY DEVRIES ” Practice Location

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