Organization
KALAMAZOO AREA REHABILITATION SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE ANDERT OT (DIRECTOR)
(269) 544-3764
Entity
Organization
Contact information
Practice address
6376 QUAIL RUN, KALAMAZOO, MI 49009-2811
(269) 544-3764
(269) 544-3767
Mailing address
6376 QUAIL RUN, KALAMAZOO, MI 49009-2811
(269) 544-3764
(269) 544-3767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64-30122
IBA/PHP ID#
MI
01
—
670C911590
BLUE CROSS SUPPLEMENTAL #
MI
Enumeration date
10/04/2006
Last updated
03/12/2009
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