Provider Demographics
NPI:1922184951
Name:VISITING THERAPISTS ASSOCIATION OF KENT, INC.
Entity Type:Organization
Organization Name:VISITING THERAPISTS ASSOCIATION OF KENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SILPA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARUPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-957-4014
Mailing Address - Street 1:1001 MEDICAL PARK DRIVE SE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3610
Mailing Address - Country:US
Mailing Address - Phone:616-957-4014
Mailing Address - Fax:616-956-0059
Practice Address - Street 1:1001 MEDICAL PARK DR SE
Practice Address - Street 2:SUITE 111
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3610
Practice Address - Country:US
Practice Address - Phone:616-957-4014
Practice Address - Fax:616-956-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P39440Medicare ID - Type UnspecifiedGROUP ORGANIZATION NUMBER