Organization
ASSOCITED ORTHOPEDIST OF DETROTI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE JOHNSON (CREDENTIALING MANAGER)
(586) 710-2307
Entity
Organization
Contact information
Practice address
50505 SCHOENHERR, SUITE 140, SHELBY TWP, MI 48301
(586) 710-2320
(586) 997-9298
Mailing address
24715 LITTLE MACK AVE STE 100, SAINT CLAIR SHORES, MI 48080-3207
(586) 779-7970
(586) 779-7748
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
55020000231
MI
Other
Enumeration date
04/25/2012
Last updated
05/22/2025
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