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Organization
SPINE DYNAMICS PHYSICAL THERAPY LLC
Active
Organization
SPINE DYNAMICS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA CANOS-TORRES PT (PHYSICAL THERAPIST)
(616) 229-4500
Entity
Organization
Contact information
Practice address
660 CASCADE WEST PKWY SE STE 25, GRAND RAPIDS, MI 49546-2142
(616) 229-4500
(616) 228-9828
Mailing address
660 CASCADE WEST PKWY SE STE 25, GRAND RAPIDS, MI 49546-2142
(616) 229-4500
(616) 228-9828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006157
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700832805
—
MI
01
—
5501006157
STATE LICENSE
MI
Enumeration date
12/07/2016
Last updated
06/20/2024
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