IndividualActive
David Trevisan, MSOP, CO
NPI 1184149551 · Orthotist · Jackson, MI
Provider details
- NPI number
- 1184149551
- Entity type
- Individual
- Primary specialty
- OrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MSOP, CO
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1407 E Michigan Ave
Jackson, MI 49202-3517
Phone: (517) 784-1142
Approximate (ZIP-level) locationGet directions
Mailing address
1407 E Michigan Ave
Jackson, MI 49202-3517
Registry dates
- Enumerated
- 2017-08-07
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.