Organization
KOCHS ORTHOTIC PROSTHETIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCELLO S. GIRAO C.O. (PRESIDENT/OWNER)
(734) 434-0442
Entity
Organization
Contact information
Practice address
5315 ELLIOTT DR, SUITE 104, YPSILANTI, MI 48197-8634
(734) 434-0442
(734) 434-1061
Mailing address
5315 ELLIOTT DR, SUITE 104, YPSILANTI, MI 48197-8634
(734) 434-0442
(734) 434-1061
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000006853
CAPE HEALTH PLAN
MI
01
—
100122
CARE CHOICES
—
01
—
P43246
BLUE CARE NETWORK
MI
Enumeration date
05/12/2006
Last updated
08/22/2020
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