Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin John Mansfield

Individual provider Physical Therapy Assistant · NPI 1376012054

Kevin John Mansfield is a Physical Therapy Assistant in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2018

Practice location Address checks out

630 Kenmoor Ave SE Ste 200
Grand Rapids, MI 49546-8626
Phone: (800) 379-1600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502001704 (MI)

Record details

NPI number1376012054
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 25, 2018
Last updated in NPPESNovember 25, 2018

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