Healthcare Provider Details

I. General information

NPI: 1982718474
Provider Name (Legal Business Name): BIG RAPIDS ORTHOPAEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 LINDEN ST SUITE 2
BIG RAPIDS MI
49307-1879
US

IV. Provider business mailing address

650 LINDEN ST SUITE 2
BIG RAPIDS MI
49307-1879
US

V. Phone/Fax

Practice location:
  • Phone: 231-796-6721
  • Fax: 231-796-1080
Mailing address:
  • Phone: 231-796-6721
  • Fax: 231-796-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TRISH LAGENDYK
Title or Position: OFFICE MANAGER
Credential:
Phone: 231-796-6721