Mrs Laurie Grace Stickler, PT | |
4565 Wilson Ave Sw, Ste 5a, Grandville, MI 49418-2371 | |
(616) 975-9078 | |
(616) 975-9248 |
Full Name | Mrs Laurie Grace Stickler |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 4565 Wilson Ave Sw, Grandville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780681882 | NPI | - | NPPES |
20-0223019 | Other | MI | TAX ID |
LS010775 | Other | MI | LICENSE NUMBER |
650D114420 | Other | MI | BLUE CROSS BLUE SHIELD |
P35364F | Other | MI | BLUE CARE NETWORK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 5501010775 (Michigan) | Primary |
Provider Name | Owens Physical Therapy Specialists, Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1629220835 PECOS PAC ID: 6002976412 Enrollment ID: O20140407001276 |
Mailing Address | Practice Location Address |
---|---|
Mrs Laurie Grace Stickler, PT 1260 Grand River Dr Ne, Ada, MI 49301-9500 Ph: () - | Mrs Laurie Grace Stickler, PT 4565 Wilson Ave Sw, Ste 5a, Grandville, MI 49418-2371 Ph: (616) 975-9078 |
Ian Larabel, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3819 Rivertown Pkwy Sw Ste 100, Grandville, MI 49418 Phone: 616-818-0018 Fax: 616-278-1451 | |
West Michigan Rehabilitation Center, Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3181 Prairie St Sw, Suite 102, Grandville, MI 49418 Phone: 616-249-3545 Fax: 616-249-3549 | |
Lisa J Vis, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5570 Wilson Ave Sw, Suite A, Grandville, MI 49418 Phone: 616-594-2000 Fax: 616-594-2004 | |
Stacie Rayman, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3380 44th St Sw, Grandville, MI 49418 Phone: 616-233-3591 Fax: 616-534-0807 | |
Laura Ann-ennis Conran, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5570 Wilson Ave Sw, Suite A, Grandville, MI 49418 Phone: 616-855-1495 Fax: 616-531-5027 | |
Ronald Kronemeyer P.t Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4120 Chicago Dr Sw, Suite #7, Grandville, MI 49418 Phone: 616-534-0366 Fax: 616-534-0540 | |
Mr. Kirk Christopher Randall, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3753 Basswood Dr Sw, Grandville, MI 49418 Phone: 616-340-6407 Fax: 616-301-2882 |