Organization
GENESYS ORTHOTHICS AND PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY D BROTHERS (PRESIDENT)
(810) 762-3662
Entity
Organization
Contact information
Practice address
841 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(810) 606-6894
Mailing address
841 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(810) 606-6894
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0990317
HEALTHPLUS OF MICHIGAN
MI
01
—
1467
BCN NORTHWOODS
MI
Enumeration date
08/10/2007
Last updated
04/20/2008
Update your record
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