Provider Demographics
NPI:1235130865
Name:OAKLAND ORTHOPEDIC APPLIANCES INC
Entity Type:Organization
Organization Name:OAKLAND ORTHOPEDIC APPLIANCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:DRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-893-7544
Mailing Address - Street 1:515 MULHOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7644
Mailing Address - Country:US
Mailing Address - Phone:989-893-7544
Mailing Address - Fax:989-893-6944
Practice Address - Street 1:1117 S VAN DYKE RD STE 100
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-8467
Practice Address - Country:US
Practice Address - Phone:989-623-0931
Practice Address - Fax:989-623-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-04
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI530Z902510OtherBCBS OF MICHIGAN
MI854376658Medicaid
MI0984027OtherHEALTH PLUS OF MICHIGAN
MI646OtherNORTHWOOD
MI52541OtherNPN NORTHWOOD
MI52541OtherABP ADMINISTRATION
MI0628060003Medicare ID - Type Unspecified