Provider Demographics
NPI:1407140874
Name:DJO CORPORATION
Entity Type:Organization
Organization Name:DJO CORPORATION
Other - Org Name:INTERIM HEALTHCARE OF ANN ARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:OTTOMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-468-3746
Mailing Address - Street 1:2010 HOGBACK RD
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9749
Mailing Address - Country:US
Mailing Address - Phone:734-468-3746
Mailing Address - Fax:734-531-5312
Practice Address - Street 1:2010 HOGBACK RD
Practice Address - Street 2:SUITE 2-A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9749
Practice Address - Country:US
Practice Address - Phone:734-468-3746
Practice Address - Fax:734-531-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health