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Contact Information

KAELEE S BROCKWAY, PT, DPT, GCS, CEEAA
1401 CEDAR ST NE
GRAND RAPIDS, MI49503-1375
 Phone: 616-260-3871
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KAELEE S BROCKWAY · (Female)

NPI # 1033611470
Status Active
Credentials PT, DPT, GCS, CEEAA
Entity Individual
Enumeration date 03/01/2018
Last updated 03/01/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MI Medicaid 1659356061
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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