Provider Demographics
NPI:1164667408
Name:OP THERAPY, LLC
Entity Type:Organization
Organization Name:OP THERAPY, LLC
Other - Org Name:IN-HOUSE DIAGNOSTIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-950-3005
Mailing Address - Street 1:7760 KOCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8655
Mailing Address - Country:US
Mailing Address - Phone:517-695-6626
Mailing Address - Fax:517-695-6873
Practice Address - Street 1:7760 KOCHVILLE RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-8655
Practice Address - Country:US
Practice Address - Phone:517-695-6626
Practice Address - Fax:517-695-6873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00816167OtherMEDICARE RAILROAD MOBLE XRAY PIN (ONE PER TAX ID)
MI700Z300280OtherBCBSM PIN
MI0Z30031OtherBCBS TECHNICAL COMPONENT PIN
MI700Z300280OtherBCBSM PIN