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NPI 1891037768

NPI 1891037768 : FAMILY ORTHOPEDIC ASSOCIATES P L C : FENTON, MI

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General NPI Number Information
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    NPI Number           |    1891037768
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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     |    03/19/2013
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    Last Update Date     |    09/19/2024
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Provider Practice Location Address
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    Address Line         |    17015 SILVER PKWY 
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    City                 |    FENTON
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    State                |    MI
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    Zip                  |    48430-3425
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    Country              |    US
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    Telephone            |    810-593-0023
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    Fax                  |    810-593-0202
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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                  |    810-733-3130
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    MI
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Taxonomy #2
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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 |    MI
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Taxonomy #3
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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 |    MI
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Taxonomy #4
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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 #5
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    MI
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Taxonomy #6
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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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