Healthcare Provider Details
I. General information
NPI: 1184913170
Provider Name (Legal Business Name): OBJECTIVE STAFFING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2011
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1164 JAMES SAVAGE RD SUITE C
MIDLAND MI
48640-6843
US
IV. Provider business mailing address
1164 JAMES SAVAGE RD SUITE C
MIDLAND MI
48640-6843
US
V. Phone/Fax
- Phone: 248-767-7568
- Fax: 734-418-1057
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 5201004576 |
| License Number State | MI |
VIII. Authorized Official
Name:
GAURAV
CHAWLA
Title or Position: CEO
Credential:
Phone: 248-767-7568