Healthcare Provider Details

I. General information

NPI: 1013105113
Provider Name (Legal Business Name): ORRISON REHABILITATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 N PAW PAW ST
COLOMA MI
49038-9567
US

IV. Provider business mailing address

429 N PAW PAW ST
COLOMA MI
49038-9567
US

V. Phone/Fax

Practice location:
  • Phone: 269-468-4745
  • Fax: 269-468-4751
Mailing address:
  • Phone: 269-468-4745
  • Fax: 269-468-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RYAN T ORRISON
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: MS PT
Phone: 269-468-4745