1770701922 NPI number — OP THERAPY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770701922 NPI number — OP THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OP THERAPY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
IN-HOUSE DIAGNOSTIC SOLUTIONS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770701922
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7760 KOCHVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREELAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48623-8655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-695-6626
Provider Business Mailing Address Fax Number:
517-695-6873

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7760 KOCHVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREELAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48623-8655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-695-6626
Provider Business Practice Location Address Fax Number:
517-695-6873
Provider Enumeration Date:
04/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COOKE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-950-3005

Provider Taxonomy Codes

  • Taxonomy code: 246XC2903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)