Organization
GREAT LAKES ORTHOPEDICS PHYSICAL THERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH PITCHFORD (PRESIDENT/CEO)
(219) 365-0220
Entity
Organization
Contact information
Practice address
9615 KEILMAN ST, SAINT JOHN, IN 46373-9406
(219) 365-0220
(219) 365-0226
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 350-2065
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
04/13/2018
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