Provider Demographics
NPI:1578364907
Name:INMAN, BRIDGET I (LMT)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:I
Last Name:INMAN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18900 W KIMBALL RD
Mailing Address - Street 2:
Mailing Address - City:PIERSON
Mailing Address - State:MI
Mailing Address - Zip Code:49339-9605
Mailing Address - Country:US
Mailing Address - Phone:606-224-8092
Mailing Address - Fax:
Practice Address - Street 1:5286 PLAINFIELD AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1047
Practice Address - Country:US
Practice Address - Phone:606-224-8092
Practice Address - Fax:606-224-8092
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501007752225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist