Individual
BRIAN MATTHEW OCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS, CERT MDT
Contact information
Practice address
4100 LAKE DR SE STE B03, GRAND RAPIDS, MI 49546-8292
(616) 267-8365
Mailing address
4100 LAKE DR SE STE B03, GRAND RAPIDS, MI 49546-8292
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501013083
MI
Other
Enumeration date
03/09/2018
Last updated
09/29/2022
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