Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cheryl Diane Bazan, PT, DPT, CKTP

Individual provider Physical Therapist · NPI 1275051153

Cheryl Diane Bazan, PT, DPT, CKTP is a Physical Therapist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2017.

Licensed in
MI
In the registry since
2017
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3075 Orchard Vista Dr SE
Grand Rapids, MI 49546-7069
Phone: (616) 301-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501015926 (MI)

Record details

NPI number1275051153
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT , CKTP
Sole proprietorNo
NPI enumeratedAugust 31, 2017
Last updated in NPPESAugust 31, 2017

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