Healthcare Provider Details

I. General information

NPI: 1629473327
Provider Name (Legal Business Name): CASCADES ORTHOPEDIC REHABILITATION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 COOPER ST
JACKSON MI
49202
US

IV. Provider business mailing address

956 COOPER ST
JACKSON MI
49202
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-3900
  • Fax:
Mailing address:
  • Phone: 517-787-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHERYL L BRAUTIGAM
Title or Position: OFFICE MANAGER
Credential:
Phone: 517-787-3900