Melinda Ann Adema, PTA

Individual provider Active NPI Physical Therapy Assistant · Grand Rapids, MI

NPI 1760098149 · NPPES record last updated Sep 21, 2020

Key facts

NPI
1760098149
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5502000219 (MI)
Practice address
4450 Cascade Rd SE Ste 200
Grand Rapids, MI 49546-3633
Phone
(616) 965-9562
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5502000219MIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502000219 MI Yes

Addresses

Primary practice location

4450 Cascade Rd SE Ste 200
Grand Rapids, MI 49546-3633

Mailing address

2156 Valley Forge St NW
Grand Rapids, MI 49504-5952
Phone (616) 450-6891

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Physical Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.