Healthcare Provider Details

I. General information

NPI: 1770701922
Provider Name (Legal Business Name): OP THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7760 KOCHVILLE RD
FREELAND MI
48623-8655
US

IV. Provider business mailing address

7760 KOCHVILLE RD
FREELAND MI
48623-8655
US

V. Phone/Fax

Practice location:
  • Phone: 517-695-6626
  • Fax: 517-695-6873
Mailing address:
  • Phone: 517-695-6626
  • Fax: 517-695-6873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN COOKE
Title or Position: PRESIDENT
Credential:
Phone: 800-950-3005