Organization
ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK REID (CEO)
(616) 459-7101
Entity
Organization
Contact information
Practice address
230 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2550
(616) 459-7101
(616) 954-6483
Mailing address
PO BOX 30516, DEPT 6063, LANSING, MI 48909-8016
(616) 459-7101
(616) 954-6483
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP01303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0442790002
MEDICARE RAILROAD NSC
MI
Enumeration date
05/14/2009
Last updated
06/27/2013
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