Clint Verran Sports Medicine, Inc
Organization Active NPI Physical Therapist · Lake Orion, MI
NPI 1013033604 · NPPES record last updated Dec 5, 2007
Key facts
- NPI
- 1013033604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501010788 (MI)
- Legal business name
- CLINT VERRAN SPORTS MEDICINE, INC
- Practice address
- 1261 S Lapeer Rd
Sutie 102
Lake Orion, MI 48360-1419 - Phone
- (248) 693-9411
- Fax
- (248) 693-9412
- NPI assigned
- Mar 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Clint Verran, PT
- Title
- Owner
- Phone
- (248) 693-9411
Practitioners 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050503000285 | MI | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2264471895 |
Receives reassigned benefits from 3 practitioners Practice locations: Rochester Hills, MI |
National Provider Directory
Locations
1928 Star Batt Dr
Ste A
Rochester Hills, MI 48309
Phone (248) 289-1168
8409 Hall Rd
Utica, MI 48317
Phone (586) 323-8039
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 5501010788 | MI | Yes |
Addresses
Primary practice location
1261 S Lapeer Rd
Sutie 102
Lake Orion, MI 48360-1419
Mailing address
1261 S Lapeer Rd
Suite 102
Lake Orion, MI 48360-1419
Phone (248) 693-9411
Other providers in Lake Orion, MI
- Sabrinia Marie Churico
- Rocco Ciccone
- Jeffery Allen Clark
- Taylor Clark
- Ashley Clendennin
- Steven Paul Cogswell
- Diana Lynn Cohen
- Richard L Cohen
- Diana R Conklin
- Ginger Connor
All providers in Lake Orion, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.