Organization
ASSOCIATED ORTHOPEDIST OF DETROIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE JOHNSON (CREDENTIALING MANAGER)
(586) 710-2307
Entity
Organization
Contact information
Practice address
24715 LITTLE MACK AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-3207
(586) 779-7970
(586) 779-7748
Mailing address
24715 LITTLE MACK AVE, SUITE 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
5502000482
MI
Other
Enumeration date
05/16/2012
Last updated
05/22/2025
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