Diversified Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501006200 Issued in MI

Legal business name

DIVERSIFIED PHYSICAL THERAPY

Practice address

1595 W Sherman Blvd
Muskegon, MI 49441-3542

Phone

(231) 755-4404

Fax

(231) 755-7704

NPI assigned

Aug 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kevin E Sprague, PT

Title

Co-Owner

Phone

(231) 755-4404

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1447443072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 CAROLYN ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494444468",
            "telephone_number": "231-755-4404",
            "fax_number": "231-755-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 W SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413542",
            "telephone_number": "231-755-4404",
            "fax_number": "231-755-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "231-755-4404",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Tai Diep, LMSW
• Timothy I. Dillivan, D.D.S.
• Kathryn Danielle Dillon Kehoe, CRNA, MS
• Steven Dillon, MD
• Disability Connection
• Thomas Andrew Dixon, P.T.A.
• DLJ Healthcare Services
• Brigitte Dodge
• Kiersten Michelle Dogger, PA-C
• Sharon L Dolislager, OT

• Physical Therapist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.