Provider Demographics
NPI: | 1629617832 |
---|---|
Name: | BLOOMFIELD HAND THERAPY PC |
Entity Type: | Organization |
Organization Name: | BLOOMFIELD HAND THERAPY PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | QUINN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 586-350-2644 |
Mailing Address - Street 1: | 33900 HARPER AVE STE 104 |
Mailing Address - Street 2: | |
Mailing Address - City: | CLINTON TWP |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48035-4258 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 586-350-2644 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1349 S ROCHESTER RD STE 215 |
Practice Address - Street 2: | |
Practice Address - City: | ROCHESTER HILLS |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48307-3152 |
Practice Address - Country: | US |
Practice Address - Phone: | 586-350-2644 |
Practice Address - Fax: | 586-541-3735 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-01-06 |
Last Update Date: | 2020-01-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty |