Organization
GATEWAY HAND THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KLEIS OTR/L CHT CLT (AUTHORIZED OFFICIAL)
(616) 209-4429
Entity
Organization
Contact information
Practice address
3739 BALDWIN ST, HUDSONVILLE, MI 49426-9733
(616) 209-4429
(616) 432-2247
Mailing address
3739 BALDWIN ST, HUDSONVILLE, MI 49426-9733
(616) 209-4429
(616) 432-2247
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
5201001229
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G00491
BCBSM
MI
05
—
1790157097
—
MI
Enumeration date
10/26/2015
Last updated
05/09/2017
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