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General NPI Number Information
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NPI Number | 1568649986
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC REHABILITATION
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 6022 HARVEY ST SUITE H
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City | MUSKEGON
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State | MI
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Zip | 49444-8802
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Country | US
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Telephone | 231-799-8883
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Fax | 231-799-8884
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Provider Business Mailing Address
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Address Line | 6022 HARVEY ST SUITE H
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City | MUSKEGON
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State | MI
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Zip | 49444-8802
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Country | US
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Telephone | 231-799-8883
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Fax | 231-799-8884
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/MEMBER
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Name | MS. MICHELLE LYNN HERTEL
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Credential | PT
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Telephone | 231-799-8883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201001131
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501004375
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License Number State | MI
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