Individual ProviderKornelis OosthoekPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2050 N Haggerty Rd Ste 280, Canton, MI 48187-3796(734) 844-0800(248) 673-6980PECOS EnrollmentBased on the most recent information from CMS, provider Kornelis Oosthoek does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1770671299Provider TypeIndividualFull NameOosthoek, KornelisCredentialPTGenderMaleSole ProprietorNoEnumeration Date10/10/2006Last Updated6/15/2009Contact InformationPractice LocationPractice Address2050 N Haggerty Rd Ste 280, Canton, MI 48187-3796Phone(734) 844-0800Fax(734) 844-0808Mailing LocationMailing Address1247 Castlewood St, White Lake, MI 48386-3720Phone(248) 673-6980Fax(248) 673-7497Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense5501003952MichiganProvider IdentifiersIDDescriptionIssuerID650F324550DescriptionOtherIssuerBLUE CROSS OF MICHIGANMichigan