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General NPI Number Information
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NPI Number | 1215930490
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Entity Type | Organization
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Legal Business Name | FAMILY ORTHOPEDIC ASSOCIATES P L C
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 4466 W BRISTOL RD
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City | FLINT
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State | MI
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Zip | 48507-3170
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Country | US
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Telephone | 810-733-1200
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Fax | 810-733-0688
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Provider Business Mailing Address
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Address Line | 4466 W BRISTOL RD
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City | FLINT
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State | MI
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Zip | 48507-3170
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Country | US
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Telephone | 810-733-1200
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Fax | 810-733-0688
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JENNIFER KELSEY
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Credential |
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Telephone | 810-733-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 4301060979
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 4301059287
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601001619
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301038287
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License Number State | MI
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