Provider Demographics
NPI:1649415936
Name:OP THERAPY, LLC
Entity Type:Organization
Organization Name:OP THERAPY, LLC
Other - Org Name:IN HOUSE DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-950-3005
Mailing Address - Street 1:24301 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3012
Mailing Address - Country:US
Mailing Address - Phone:800-950-3005
Mailing Address - Fax:248-356-9297
Practice Address - Street 1:24301 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3012
Practice Address - Country:US
Practice Address - Phone:800-950-3005
Practice Address - Fax:248-356-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F38652OtherBCBS
MIP00816167OtherMEDICARE RAILROAD
MIP00816167OtherMEDICARE RAILROAD