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Contact Information

GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC
1159 S HARBOR DR
SUITE C-4
GRAND HAVEN, MI49417-1777
 Phone: 616-844-4067
 Fax: 616-844-4067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GERIATRIC EXTENDED REHABILITATION MEDICINE LLC · (Female)

NPI Number 1609810985
Status Active
Credentials
Entity Individual
Enumeration date 06/16/2006
Last updated 10/04/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 5101009705
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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