Organization
GREAT LAKES THERAPY AT ORCHARD CREEK CAMPUS
Active
Organization
GREAT LAKES THERAPY AT ORCHARD CREEK CAMPUS
Active
Parent organization
GREAT LAKES THERAPY HOUSE CALLS
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES THERAPY HOUSE CALLS
Authorized official
JAMES A HARVEY MSPT (PHYSICAL THERAPIST/OWNER)
(231) 642-6166
Entity
Organization
Contact information
Practice address
1650 BARLOW ST, TRAVERSE CITY, MI 49686-4721
(231) 941-3100
Mailing address
9731 E CHERRY BEND RD, TRAVERSE CITY, MI 49684-7621
(231) 929-8180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N83550
MEDICARE GROUP
MI
01
—
0N86360
MEDICARE GROUP
MI
Enumeration date
10/01/2009
Last updated
10/01/2009
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