Provider Demographics
NPI:1740677236
Name:ORTHOPAEDIC TEAM REHABILITATION LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC TEAM REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-999-8330
Mailing Address - Street 1:28001 SCHOENHERR RD STE 6
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-4396
Mailing Address - Country:US
Mailing Address - Phone:586-999-8330
Mailing Address - Fax:586-999-8331
Practice Address - Street 1:28001 SCHOENHERR RD STE 6
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4396
Practice Address - Country:US
Practice Address - Phone:586-999-8330
Practice Address - Fax:586-999-8331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty