Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSE BRYAN NICODEMUS, MOT
Active Sole ProprietorJESSE BRYAN NICODEMUS, MOT is a Occupational Therapist healthcare provider located in GRAND RAPIDS, Michigan. NPI 1386114734 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1386114734
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 28, 2018 (7.6710444527712 yrs)
- Last Updated
- Nov 28, 2018
- License
-
201009340 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2320 E BELTLINE AVE SEGRAND RAPIDS, MI, 495465906Browse MI providers · Browse ZIP 49546
- Phone
- 6168318666
- Primary Specialty
-
Occupational Therapist
225X00000X
Other Occupational Therapist Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| DIANN FISK | OTR | 1427034032 |
| STEPHEN J KOSIARA | OTR | 1801872411 |
| MRS. JENNIFER L VELLIQUETTE | OTR/L | 1336161553 |
| SARAH HOEKSTRA | — | 1538241740 |
| MRS. PAULA LYNETTE HAWKINS-GUY | OTR/L | 1932281565 |
| MR. BABAN V NAIK | OTR | 1942386222 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.