Healthcare Provider Details

I. General information

NPI: 1124487392
Provider Name (Legal Business Name): ELI OCHSHORN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8491 W GRAND RIVER AVE STE 600
BRIGHTON MI
48116-4359
US

IV. Provider business mailing address

600 OAKMONT LN STE 600C
WESTMONT IL
60559-5548
US

V. Phone/Fax

Practice location:
  • Phone: 810-225-1187
  • Fax: 810-225-1284
Mailing address:
  • Phone: 630-575-6250
  • Fax: 630-575-7450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number550107595
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: