Healthcare Provider Details

I. General information

NPI: 1407960214
Provider Name (Legal Business Name): DJ BUSINESSES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 W U AVE
SCHOOLCRAFT MI
49087-9462
US

IV. Provider business mailing address

4317 W U AVE
SCHOOLCRAFT MI
49087-9462
US

V. Phone/Fax

Practice location:
  • Phone: 269-375-2200
  • Fax: 269-216-6364
Mailing address:
  • Phone: 269-375-2200
  • Fax: 269-216-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DALE J OBRYANT
Title or Position: PRESIDENT
Credential: OTR
Phone: 269-375-2200