Organization
NORTHWEST ORTHOTICS PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG V GREENWAY CP (GENERAL MANAGER, CERTIFIED PROSTHE)
(248) 477-1443
Entity
Organization
Contact information
Practice address
39830 GRAND RIVER AVE, SUITE B1D, NOVI, MI 48375-2140
(248) 477-1443
(248) 477-1509
Mailing address
39830 GRAND RIVER AVE, SUITE B1D, NOVI, MI 48375-2140
(248) 477-1443
(248) 477-1509
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
B ME 0149837
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010487
CAPE HEALTH PLAN
MI
05
—
4404770 85
—
MI
01
—
530F309270
BCBS OF MICHIGAN
MI
01
—
P80616
BLUE CARE NETWORK
MI
Enumeration date
07/11/2005
Last updated
01/20/2023
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