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Organization

OP THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN COOKE (PRESIDENT)
(800) 950-3005
Entity
Organization

Contact information

Practice address
24301 TELEGRAPH RD, SOUTHFIELD, MI 48033-3012
(800) 950-3005
(248) 356-9297
Mailing address
24301 TELEGRAPH RD, SOUTHFIELD, MI 48033-3012
(800) 950-3005
(248) 356-9297

Taxonomy

Speciality
Code
Description
License number
State
246X00000X
Cardiovascular Specialist/Technologist
Primary
246XC2903X
Vascular Specialist/Technologist Cardiovascular
2471V0106X
Vascular-Interventional Technology Radiologic Technologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
700F386490
BCBSM PIN
MI
01
P00816164
MEDICARE RAILROAD
MI
Enumeration date
12/12/2008
Last updated
07/09/2010
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