Provider Demographics
NPI:1407960214
Name:DJ BUSINESSES INC
Entity Type:Organization
Organization Name:DJ BUSINESSES INC
Other - Org Name:PAIN RELEASE THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OBRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:269-375-2200
Mailing Address - Street 1:4317 W U AVE
Mailing Address - Street 2:
Mailing Address - City:SCHOOLCRAFT
Mailing Address - State:MI
Mailing Address - Zip Code:49087-9462
Mailing Address - Country:US
Mailing Address - Phone:269-375-2200
Mailing Address - Fax:269-216-6364
Practice Address - Street 1:4317 W U AVE
Practice Address - Street 2:
Practice Address - City:SCHOOLCRAFT
Practice Address - State:MI
Practice Address - Zip Code:49087-9462
Practice Address - Country:US
Practice Address - Phone:269-375-2200
Practice Address - Fax:269-216-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION86580Medicare ID - Type Unspecified