Provider Demographics
NPI:1760594360
Name:VRUGGINK, TORREY J (PT)
Entity Type:Individual
Prefix:
First Name:TORREY
Middle Name:J
Last Name:VRUGGINK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 N STATE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1281
Mailing Address - Country:US
Mailing Address - Phone:616-748-1140
Mailing Address - Fax:616-748-1150
Practice Address - Street 1:26 N STATE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1281
Practice Address - Country:US
Practice Address - Phone:616-748-1140
Practice Address - Fax:616-748-1150
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501009059OtherPHYSICAL THERAPIST