Provider Demographics
NPI:1740945443
Name:OOSTHOEK PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:OOSTHOEK PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KORNELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OOSTHOEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-318-0026
Mailing Address - Street 1:1247 CASTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3720
Mailing Address - Country:US
Mailing Address - Phone:248-318-0026
Mailing Address - Fax:
Practice Address - Street 1:24530 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1711
Practice Address - Country:US
Practice Address - Phone:313-759-0777
Practice Address - Fax:313-749-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty