| Doctor Name: | MRS. EILEEN MARIE KISHMAN |
| NPI Number: | 1609069244 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 5501003198 |
| Business Practice Address: | 15151 Stanton St Suite B West Olive, MI - 494608543 |
| Business Phone Number: | 6162969235 |
| Business Fax Number: | 6162969236 |
| Mailing Address: | 2335 Mission Hills Dr Se, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495465587 |
| Phone Number: | 6169498599 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2007 |
| NPI Last Update Date: | 10/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501003198 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |