Healthcare Provider Details

I. General information

NPI: 1619956646
Provider Name (Legal Business Name): ORTHOPAEDIC REHAB SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 N WEST AVE STE B
JACKSON MI
49201-1903
US

IV. Provider business mailing address

3073 SHIRLEY DR
JACKSON MI
49201-7010
US

V. Phone/Fax

Practice location:
  • Phone: 517-783-6670
  • Fax: 517-783-5310
Mailing address:
  • Phone: 517-990-6211
  • Fax: 517-990-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. BRANDON KLUMP
Title or Position: COO, CO-OWNER, PT
Credential: PT
Phone: 517-783-6670