Healthcare Provider Details

I. General information

NPI: 1205059615
Provider Name (Legal Business Name): MESSER ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 E BELTLINE AVE NE SUITE C
GRAND RAPIDS MI
49525-1097
US

IV. Provider business mailing address

4955 E BELTLINE DR NE SUITE C
GRAND RAPIDS MI
49525-1097
US

V. Phone/Fax

Practice location:
  • Phone: 616-447-9000
  • Fax: 616-447-9001
Mailing address:
  • Phone: 616-447-9000
  • Fax: 616-447-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberCO003326
License Number State

VIII. Authorized Official

Name: MR. BILL J MESSER
Title or Position: MANAGER
Credential: CO
Phone: 616-447-9000