Healthcare Provider Details

I. General information

NPI: 1689667842
Provider Name (Legal Business Name): KEVIN R ORLOSKI MD, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N MICHIGAN AVE STE 7
SAGINAW MI
48602-4751
US

IV. Provider business mailing address

5345 ORCHARD RIDGE DR
ROCHESTER MI
48306-2398
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-2720
  • Fax: 989-583-1888
Mailing address:
  • Phone: 248-534-6626
  • Fax: 888-653-8521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038008150
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010255
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036-137314
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4301101777
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: