Provider Demographics
NPI:1013105113
Name:ORRISON REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:ORRISON REHABILITATION SERVICES, LLC
Other - Org Name:TRI-CITY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:269-468-4745
Mailing Address - Street 1:429 N PAW PAW ST
Mailing Address - Street 2:
Mailing Address - City:COLOMA
Mailing Address - State:MI
Mailing Address - Zip Code:49038-9567
Mailing Address - Country:US
Mailing Address - Phone:269-468-4745
Mailing Address - Fax:269-468-4751
Practice Address - Street 1:429 N PAW PAW ST
Practice Address - Street 2:
Practice Address - City:COLOMA
Practice Address - State:MI
Practice Address - Zip Code:49038-9567
Practice Address - Country:US
Practice Address - Phone:269-468-4745
Practice Address - Fax:269-468-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION97550Medicare PIN