Provider Demographics
NPI:1528530839
Name:THORNAPPLE RIVER ORTHOPEDICS PC
Entity type:Organization
Organization Name:THORNAPPLE RIVER ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:616-266-9100
Mailing Address - Street 1:7169 KALAMAZOO AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8146
Mailing Address - Country:US
Mailing Address - Phone:616-266-9100
Mailing Address - Fax:616-266-9200
Practice Address - Street 1:7169 KALAMAZOO AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316
Practice Address - Country:US
Practice Address - Phone:616-266-9100
Practice Address - Fax:616-266-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty