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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033611470 NPPES
Michigan MEDICAID 1659356061

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