| Spine Dynamics Physical Therapy Llc | |
|
660 Cascade West Pkwy Se Ste 25, Grand Rapids, MI 49546-2142 | |
| (616) 229-4500 | |
| (616) 228-9828 |
| Full Name | Spine Dynamics Physical Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 660 Cascade West Pkwy Se Ste 25, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487198677 | NPI | - | NPPES |
| 5501006157 | Other | MI | STATE LICENSE |
| 1700832805 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501006157 (Michigan) | Primary |
| Provider Name | Alicia Canos Torres |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700832805 PECOS PAC ID: 3274543913 Enrollment ID: I20060426000319 |
| Provider Name | Brad A Johanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407289622 PECOS PAC ID: 4284868993 Enrollment ID: I20180124001320 |
| Mailing Address | Practice Location Address |
|---|---|
| Spine Dynamics Physical Therapy Llc 660 Cascade West Pkwy Se Ste 25, Grand Rapids, MI 49546-2142 Ph: (616) 229-4500 | Spine Dynamics Physical Therapy Llc 660 Cascade West Pkwy Se Ste 25, Grand Rapids, MI 49546-2142 Ph: (616) 229-4500 |
Ms. Silpa Parupalli, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6252 Architrave St Se, Grand Rapids, MI 49546 Phone: 616-446-1374 Fax: 616-956-0059 | |
Ryan Sanders Gary, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1331 Lake Dr Se, Suite 105, Grand Rapids, MI 49506 Phone: 616-248-9842 Fax: 616-248-9848 | |
Samantha Michelle Flietstra, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2161 Leonard St Nw, Grand Rapids, MI 49504 Phone: 616-453-7715 | |
Jennifer Lynne Taylor, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 235 Wealthy St Se, Grand Rapids, MI 49503 Phone: 616-262-0299 | |
Katharine Lind Thompson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 Jefferson Ave Se, Grand Rapids, MI 49503 Phone: 616-685-6264 | |
Dr. Lindsey Danielle Conrado, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Michigan St Ne, Grand Rapids, MI 49503 Phone: 161-639-1177 | |
Lauren Mallory, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 235 Wealthy St Se, Grand Rapids, MI 49503 Phone: 616-840-8000 |