Provider Demographics
NPI:1346657863
Name:O'BRIEN, STEPHEN RACHEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RACHEL
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7809
Mailing Address - Country:US
Mailing Address - Phone:810-406-9466
Mailing Address - Fax:810-603-2509
Practice Address - Street 1:4250 N SAGINAW ST STE C
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-5332
Practice Address - Country:US
Practice Address - Phone:810-406-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist