Great Lakes Physical Therapies, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5501011546 Issued in MI

Legal business name

GREAT LAKES PHYSICAL THERAPIES, LLC

Practice address

921 S Beechtree St
Suite 5
Grand Haven, MI 49417-2385

Phone

(616) 842-0555

NPI assigned

Oct 3, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Link A Dephouse Sr., PT

Title

PT/Owner

Phone

(616) 842-5555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1962653378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S BEECHTREE ST",
            "address_2": "SUITE 5",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172385",
            "telephone_number": "616-842-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S BEECHTREE ST",
            "address_2": "SUITE 5",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172385",
            "telephone_number": "616-842-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PHYSICAL THERAPIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "DEPHOUSE",
        "authorized_official_first_name": "LINK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "616-842-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501011546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Haven Speech Partners, LLC
• Grand Pines Assisted Living Center
• Emily Gray
• Great Lakes Chiropractic Health
• Great Lakes Compounding Pharmacy
• Liza M Greene, PA-C
• Sharon Lynn Griswold, L.M.S.W.
• Mallory Groenevelt
• Sara Grossenbacher, OT
• Susan Hackney, RPH

• All providers in Grand Haven, MI
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.