Healthcare Provider Details

I. General information

NPI: 1295188365
Provider Name (Legal Business Name): ROCHESTER KNEE & SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CROSS CREEK PKWY STE 110
AUBURN HILLS MI
48326
US

IV. Provider business mailing address

3100 CROSS CREEK PKWY STE 200
AUBURN HILLS MI
48326-2776
US

V. Phone/Fax

Practice location:
  • Phone: 248-377-8000
  • Fax:
Mailing address:
  • Phone: 248-377-8000
  • Fax: 248-377-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR NEWKIRK
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 248-377-8000