MEDICARE: ROPP ORTHOPEDIC CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104802784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPP ORTHOPEDIC CLINIC LLC

Provider Business Mailing Address
First Line	:	2075 E WEST MAPLE RD
Second Line	:	STE B-207
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48390-3816
Country	:	US
Telephone Number	:	248-669-9222
Fax Number	:	248-669-3866

Provider Business Practice Location Address
First Line	:	2075 E WEST MAPLE RD
Second Line	:	STE B-207
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48390-3816
Country	:	US
Telephone Number	:	248-669-9222
Fax Number	:	248-669-3866

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JEFFREY DALE ROPP
Credential	:	C.P.
Telephone Number	:	248-669-9222

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/05/2008

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