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Grand Rapids Physical Therapy & Performance — NPI 1083203400, Grand Rapids, MI | NPI Central

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Grand Rapids Physical Therapy & Performance

NPI 1083203400 · Sports Physical Therapist · Grand Rapids, MI

Provider details

NPI number: 1083203400
Entity type: Organization
Primary specialty: Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Organization subpart: No
Authorized official: Joseph Hanisko, Owner/Pt(989) 780-2748

Specialties & taxonomies

Sports Physical TherapistPrimary2251S0007X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Practice location

1236 Plymouth Ave Ne

Grand Rapids, MI 49505-5641

Phone: (989) 780-2748

Approximate (ZIP-level) locationGet directions

More MI providers

Mailing address

1236 Plymouth Ave Ne

Grand Rapids, MI 49505-5641

Other names (DBA / former)

Doing business as: Onward Grand Rapids

Registry dates

Enumerated: 2021-01-11
Last updated: 2021-01-11
Certified: 2021-01-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.