Doctor Name: | KELLY O'ROURKE |
NPI Number: | 1629481635 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5501016792 |
Business Practice Address: | 416 S Creyts Rd Suite B Lansing, MI - 489178290 |
Business Phone Number: | 5173270966 |
Business Fax Number: | 5173270986 |
Mailing Address: | 1701 Lake Lansing Rd, Suite 100 LANSING |
State: | MI |
Postal Code: | 489123798 |
Phone Number: | 5174850001 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2014 |
NPI Last Update Date: | 06/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501016792 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |