Provider Demographics
NPI:1932372810
Name:AINSLIE, FREDERICK STUART (OTR)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:STUART
Last Name:AINSLIE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 E CLOVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-1606
Mailing Address - Country:US
Mailing Address - Phone:906-932-4200
Mailing Address - Fax:
Practice Address - Street 1:1310 E CLOVERLAND DR
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-1606
Practice Address - Country:US
Practice Address - Phone:906-932-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1899026225X00000X
MI5201000918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist