Provider Demographics
NPI:1205478344
Name:PLANTINGA, BRIAR ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:BRIAR
Middle Name:ELIZABETH
Last Name:PLANTINGA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 BURWOOD HILL DR
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9422
Mailing Address - Country:US
Mailing Address - Phone:616-560-3728
Mailing Address - Fax:
Practice Address - Street 1:10263 CHICAGO DR
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1416
Practice Address - Country:US
Practice Address - Phone:616-741-9320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010724225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist