Healthcare Provider Details

I. General information

NPI: 1639618861
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8777 PLATT RD
SALINE MI
48176-9773
US

IV. Provider business mailing address

5080 SPECTRUM DR STE 1200W
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 734-695-6301
  • Fax: 734-695-6302
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN ANDERSON
Title or Position: SR VP, CMO
Credential: DO, MPH
Phone: 972-364-8000