Organization
ORTHOPEDIC MEDICAL RECREATION
Active
Organization
ORTHOPEDIC MEDICAL RECREATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS LENA WINCHESTER (DIRECTOR OF OPERATIONS)
(248) 595-8800
Entity
Organization
Contact information
Practice address
15600 W 12 MILE RD, SOUTHFIELD, MI 48076-3068
(248) 595-8800
(248) 595-8517
Mailing address
15600 W 12 MILE RD, SOUTHFIELD, MI 48076-3068
(248) 595-8800
(248) 595-8517
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
Update your record
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