Organization
OP THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN COOKE (PRESIDENT)
(800) 950-3005
Entity
Organization
Contact information
Practice address
131 S MAIN ST, PLAINWELL, MI 49080-1683
(269) 685-5604
Mailing address
131 S MAIN ST, PLAINWELL, MI 49080-1683
(269) 685-5604
Taxonomy
Speciality
Code
Description
License number
State
246X00000X
Cardiovascular Specialist/Technologist
Primary
—
MI
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700Z300290
BCBSM PIN
MI
01
—
P00816164
MEDICARE RAILROAD IDTF (ONE PER TAX ID)
MI
Enumeration date
12/12/2008
Last updated
07/09/2010
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