Provider Demographics
NPI:1346291150
Name:OP THERAPY, INC
Entity Type:Organization
Organization Name:OP THERAPY, INC
Other - Org Name:IN HOUSE DIAGNOSTIC SERVICES
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 1:24301 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3012
Mailing Address - Country:US
Mailing Address - Phone:800-950-3005
Mailing Address - Fax:248-356-9297
Practice Address - Street 1:24301 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3012
Practice Address - Country:US
Practice Address - Phone:800-950-3005
Practice Address - Fax:248-356-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F329390OtherBCBSM
MI0F329390OtherBCBSM