Brockway, Kaelee Sara
Brockway, Kaelee Sara is an individual health care provider with primary practice located at 1401 Cedar St Ne , Grand Rapids MI 49503-1375. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, which is considered as her primary health care specialty. Brockway, Kaelee Sara can be contacted via phone (616) 260-3871.Contact Information
Primary practice address
1401 Cedar St Ne
Grand Rapids MI 49503-1375
Phone: (616) 260-3871
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X |
Profile Details
| NPI number | 1033611470 |
|---|---|
| LBN Legal business name | Brockway, Kaelee Sara |
| Credentials | PT, DPT, GCS, CEEAA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2018 |
| Last updated | Mar 1st, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033611470 | NPPES |
| Michigan | MEDICAID | 1659356061 |
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