Individual
ELINA SIMONEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 KENMOOR AVE SE STE 200, GRAND RAPIDS, MI 49546-8626
(616) 975-6200
(616) 975-5400
Mailing address
630 KENMOOR AVE SE STE 200, GRAND RAPIDS, MI 49546-8626
(616) 975-6200
(616) 975-5400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012209
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501012209
PHYSICAL THERAPY
MI
Enumeration date
11/19/2018
Last updated
11/19/2018
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