Individual
EMILY EISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
437 BUTTERNUT DR, HOLLAND, MI 49424-1577
(616) 355-3055
(616) 317-5269
Mailing address
PO BOX 412031, BOSTON, MA 02241-2031
(914) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018371
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501018371
LICENSE
MI
Enumeration date
11/27/2017
Last updated
09/24/2024
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