1780951541 NPI number — MS. DEBORAH JANE SPRINGER M.A,, AT, ATC

Table of content: MS. DEBORAH JANE SPRINGER M.A,, AT, ATC (NPI 1780951541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780951541 NPI number — MS. DEBORAH JANE SPRINGER M.A,, AT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPRINGER
Provider First Name:
DEBORAH
Provider Middle Name:
JANE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A,, AT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780951541
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
116 STURRUS, 1607 ROBINSON RD. SE
Provider Second Line Business Mailing Address:
AQUINAS COLLEGE
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49506-1799
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-632-2897
Provider Business Mailing Address Fax Number:
616-732-4548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1607 ROBINSON RD SE
Provider Second Line Business Practice Location Address:
116 STURRUS
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49506-1741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-632-2897
Provider Business Practice Location Address Fax Number:
616-732-4548
Provider Enumeration Date:
11/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  2601000521 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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