Kalamazoo Functional Rehabiliation- Therapy Team LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KALAMAZOO FUNCTIONAL REHABILIATION- THERAPY TEAM LLC

Practice address

6376 Quail Run Dr
Kalamazoo, MI 49009-2811

Phone

(269) 544-3764

NPI assigned

Aug 16, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie BolNPI 1194090332

Title

Owner/Speech Language Pathologist

Phone

(269) 870-6459

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Ann Bol, CCC-SLP

  • Speech-Language Pathologist
  • Kalamazoo, MI
  • NPI 1194090332
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1902154388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 OLD COLONY RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490084915",
            "telephone_number": "269-870-6459",
            "fax_number": "269-978-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6376 QUAIL RUN DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092811",
            "telephone_number": "269-544-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMAZOO FUNCTIONAL REHABILIATION- THERAPY TEAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "BOL",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "269-870-6459"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.