Organization
BAYSHORE HAND REHABILITATION
Active
Organization
BAYSHORE HAND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE ROOST OTRL, CHT (OTRL, CHT, OWNER)
(760) 712-9309
Entity
Organization
Contact information
Practice address
4110 COPPER RIDGE DR STE 204D, TRAVERSE CITY, MI 49684-6721
(231) 300-8411
Mailing address
428 W 8TH ST, TRAVERSE CITY, MI 49684-3105
(760) 712-9309
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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