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

Last updated

Mar 10, 2009By the provider in NPPES

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., PTNPI 1710071360

Title

PT/Owner

Phone

(616) 842-5555

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Link A Dephouse, PT

  • Physical Therapist
  • Grand Haven, MI
  • NPI 1710071360
  Authorized official Same address or phone

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 Health & Wellness of Grand Haven)
• Great Lakes Compounding Pharmacy
• Chelsea Green
• Liza M Greene, PA-C
• Sharon Lynn Griswold, L.M.S.W.
• Mallory Groenevelt
• Sara Grossenbacher, OT

• Physical Therapy Clinic/Center in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• 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.