Provider Demographics
NPI:1073608907
Name:OROW, JEFFREY SAM (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SAM
Last Name:OROW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8910 CLUBWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-1752
Mailing Address - Country:US
Mailing Address - Phone:248-227-5333
Mailing Address - Fax:
Practice Address - Street 1:6621 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3004
Practice Address - Country:US
Practice Address - Phone:248-862-6407
Practice Address - Fax:248-757-2309
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010128202251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic