Individual
JAMIE LYNN RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4955 EAST BELTLINE AVE NE, SUITE A, GRAND RAPIDS, MI 49525
(616) 447-4090
(616) 447-4098
Mailing address
1106 WALWOOD DR NE, GRAND RAPIDS, MI 49505-5944
(616) 447-4090
(616) 447-4098
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010869
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2554102735
BCBS
MI
Enumeration date
10/26/2006
Last updated
04/11/2008
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