Healthcare Provider Details

I. General information

NPI: 1326436817
Provider Name (Legal Business Name): FAMILY ORTHOPEDIC ASSOCIATES P L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4466 W BRISTOL RD
FLINT MI
48507-3170
US

IV. Provider business mailing address

4466 W BRISTOL RD
FLINT MI
48507-3170
US

V. Phone/Fax

Practice location:
  • Phone: 810-285-8523
  • Fax: 810-820-9582
Mailing address:
  • Phone: 810-733-1200
  • Fax: 810-733-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMI

VIII. Authorized Official

Name: JENNIFER KELSEY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 810-733-1200