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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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