Organization
GRAND RIVER REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM JOSEPH RUSH MD (OWNER)
(616) 780-7389
Entity
Organization
Contact information
Practice address
412 PLYMOUTH AVE NE, GRAND RAPIDS, MI 49505-6028
(616) 780-2324
(877) 991-4975
Mailing address
412 PLYMOUTH AVE NE, GRAND RAPIDS, MI 49505-6028
(616) 780-2324
(877) 991-4975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301091218
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301091218
MI
2081P0010X
Pediatric Rehabilitation Medicine Physician
4301091218
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528095643
NPI ENUMERATOR
—
Enumeration date
05/19/2018
Last updated
05/12/2023
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