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General NPI Number Information
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NPI Number | 1811197593
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Entity Type | Organization
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Legal Business Name | HASTINGS ORTHOPEDIC CLINIC
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 840 COOK RD
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City | HASTINGS
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State | MI
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Zip | 49058-9616
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Country | US
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Telephone | 269-945-4966
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Fax | 269-945-3368
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Provider Business Mailing Address
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Address Line | 840 COOK RD
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City | HASTINGS
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State | MI
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Zip | 49058-9616
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Country | US
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Telephone | 269-945-4966
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Fax | 269-945-3368
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | KENNETH MERRIMAN
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Credential | MD
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Telephone | 269-945-4966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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