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General NPI Number Information
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NPI Number | 1528530839
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Entity Type | Organization
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Legal Business Name | THORNAPPLE RIVER ORTHOPEDICS PC
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 7169 KALAMAZOO AVE SE STE 100
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City | CALEDONIA
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State | MI
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Zip | 49316
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Country | US
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Telephone | 616-266-9100
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Fax | 616-266-9200
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Provider Business Mailing Address
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Address Line | 7169 KALAMAZOO AVE SE STE 100
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City | CALEDONIA
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State | MI
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Zip | 49316-8146
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Country | US
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Telephone | 616-266-9100
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Fax | 616-266-9200
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES HORTON JR.
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Credential | DO
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Telephone | 616-266-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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