Provider Demographics
NPI:1578666434
Name:POST, VIRGINIA ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:ELIZABETH
Last Name:POST
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:E
Other - Last Name:BORGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6485 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-8921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:607 DEWEY AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-7335
Practice Address - Country:US
Practice Address - Phone:616-356-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1578666434Medicaid
MI382617193OtherTAX ID#