Provider Demographics
NPI:1215261938
Name:ABOVE AND BEYOND ORTHOPEDICS LLC
Entity type:Organization
Organization Name:ABOVE AND BEYOND ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YAVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MITCHELL-MONEY
Authorized Official - Suffix:
Authorized Official - Credentials:BOCCP
Authorized Official - Phone:313-965-7884
Mailing Address - Street 1:525 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-4324
Mailing Address - Country:US
Mailing Address - Phone:313-965-7884
Mailing Address - Fax:
Practice Address - Street 1:525 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-4324
Practice Address - Country:US
Practice Address - Phone:313-965-7884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MI335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies