Individual
JAMES PATRICK GAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8684
(616) 840-9771
Mailing address
54 GREYSTONE CT NE, ROCKFORD, MI 49341-1528
(616) 915-2136
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501012506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437402542
—
MI
Enumeration date
02/22/2018
Last updated
02/22/2018
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