Organization
KASIM LTD
Active
Other names
Comprehensive Physical Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE R BENT (BUSINESS MANAGER)
(616) 785-8535
Entity
Organization
Contact information
Practice address
1550 3 MILE RD NW, SUITE B, GRAND RAPIDS, MI 49544-8251
(616) 785-8535
(616) 785-1201
Mailing address
1550 3 MILE RD NW, SUITE B, GRAND RAPIDS, MI 49544-8251
(616) 785-8535
(616) 785-1201
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30656
BLUE CROSS BLUE SHIELD
MI
05
—
3343400
—
MI
Enumeration date
05/13/2006
Last updated
12/09/2015
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