Provider Demographics
NPI:1417033416
Name:ORTHOPAEDIC THERAPY, INC.
Entity Type:Organization
Organization Name:ORTHOPAEDIC THERAPY, INC.
Other - Org Name:OTI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BEISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-783-2739
Mailing Address - Street 1:PO BOX 1447
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-1447
Mailing Address - Country:US
Mailing Address - Phone:517-783-2739
Mailing Address - Fax:517-783-6450
Practice Address - Street 1:728 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2008
Practice Address - Country:US
Practice Address - Phone:517-783-2739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty