Individual provider · Type 1 NPI

Gracie Jo Landes, PTA

Physical Therapy Assistant · Grand Rapids, MI

NPI number 1255294971 Active

Practice location

4150 Kalamazoo Ave SE
Grand Rapids, MI 49508-3605

Call (616) 913-2006 Map

Mailing address

6259 Usborne Rd
Freeport, MI 49325-9443

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X5502008884 (MI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1255294971

Gracie Jo Landes, PTA's National Provider Identifier is 1255294971, issued on Dec 9, 2025. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 9, 2025.