Organization
RIVER VALLEY ORTHOPEDICS, P.C.
Active
Parent organization
RIVER VALLEY ORTHOPEDICS, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVER VALLEY ORTHOPEDICS, P.C.
Authorized official
JOEL YOUNG (REVENUE CYCLE DIRECTOR)
(616) 459-7101
Entity
Organization
Contact information
Practice address
350 LAFAYETTE AVE SE FL 4, GRAND RAPIDS, MI 49503-4656
(616) 456-8515
(616) 456-8208
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OM51600
MEDICARE
MI
Enumeration date
09/21/2018
Last updated
03/14/2019
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