Provider Demographics
NPI:1558517615
Name:BRIGGS, JODI L (MSPT)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:L
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:L
Other - Last Name:BOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11301 COMMERCE DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8200
Mailing Address - Country:US
Mailing Address - Phone:616-895-4770
Mailing Address - Fax:616-469-1667
Practice Address - Street 1:11301 COMMERCE DR STE B
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8200
Practice Address - Country:US
Practice Address - Phone:616-895-4770
Practice Address - Fax:616-469-1667
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010601225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501010601OtherMI LICENSE NUMBER