Provider Demographics
NPI:1831438670
Name:YUENGER, BRANDON MICHAEL (PT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:MICHAEL
Last Name:YUENGER
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 1:800 MONROE AVE NW STE 320
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1451
Mailing Address - Country:US
Mailing Address - Phone:734-646-4221
Mailing Address - Fax:616-319-4657
Practice Address - Street 1:800 MONROE AVE NW STE 320
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1451
Practice Address - Country:US
Practice Address - Phone:734-646-4221
Practice Address - Fax:616-319-4657
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist