Joshua Paul Ahlstrom, CPO
Individual provider Active NPI Orthotist · Jackson, MI
NPI 1003338898 · NPPES record last updated Jul 12, 2017
Key facts
- NPI
- 1003338898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthotist 222Z00000X
- License
- CPO2466 (MI)
- Practice address
- 1407 E Michigan Ave
Jackson, MI 49202-3517 - Phone
- (517) 784-1142
- NPI assigned
- Jul 12, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPO2466 | MI | MD | Orthotist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CPO2466 | MI | Yes |
Addresses
Primary practice location
1407 E Michigan Ave
Jackson, MI 49202-3517
Mailing address
1407 E Michigan Ave
Jackson, MI 49202-3517
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.