Healthcare Provider Details

I. General information

NPI: 1104802784
Provider Name (Legal Business Name): ROPP ORTHOPEDIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 E WEST MAPLE RD STE B-207
COMMERCE TOWNSHIP MI
48390-3816
US

IV. Provider business mailing address

2075 E WEST MAPLE RD STE B-207
COMMERCE TOWNSHIP MI
48390-3816
US

V. Phone/Fax

Practice location:
  • Phone: 248-669-9222
  • Fax: 248-669-3866
Mailing address:
  • Phone: 248-669-9222
  • Fax: 248-669-3866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY DALE ROPP
Title or Position: DIRECTOR
Credential: C.P.
Phone: 248-669-9222