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

Stacey Marie Omiljan, DPT

Individual provider Physical Therapist · NPI 1972005668

Stacey Marie Omiljan, DPT is a Physical Therapist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2018.

Licensed in
MI
In the registry since
2018
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

5060 Cascade Rd SE Ste A
Grand Rapids, MI 49546-3808
Phone: (616) 954-0950
Fax: (616) 954-1728
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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 5501018376 (MI)

Record details

NPI number1972005668
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 8, 2018
Last updated in NPPESAugust 12, 2020
Certification dateAugust 12, 2020

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