| Mr Richard Nathan Kornspan, OTR/L | |
| 
					19401 Northline Rd, Southgate, MI 48195-2277  | |
| (734) 785-7705 | |
| Not Available | 
| Full Name | Mr Richard Nathan Kornspan | 
|---|---|
| Gender | Male | 
| Speciality | Occupational Therapist | 
| Location | 19401 Northline Rd, Southgate, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104037944 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary | 
| Provider Name | Behavioral Outcomes Management,llc | 
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Provider Identifiers | NPI Number: 1184139131 PECOS PAC ID: 1355602426 Enrollment ID: O20180306002107  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Richard Nathan Kornspan, OTR/L 35986 Fair Oaks Ct, Farmington Hills, MI 48331-3118 Ph: (248) 488-0244  | Mr Richard Nathan Kornspan, OTR/L 19401 Northline Rd, Southgate, MI 48195-2277 Ph: (734) 785-7705  | 
Kristen Collins,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 19401 Northline Rd, Southgate, MI 48195 Phone: 734-785-7718  | |
Lisa Logomarsino,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 13101 Allen Rd, Southgate, MI 48195 Phone: 734-785-7700  | |
Sarah Renner,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 13161 Mercier St, Southgate, MI 48195 Phone: 719-377-7515  | |
Ms. Julie Ann Farer, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 19275 Northline Rd, Southgate, MI 48195 Phone: 734-785-7705 Fax: 734-287-1679  | |
Judith M Garf, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 15830 Fort St, Suite 6, Southgate, MI 48195 Phone: 734-324-2980 Fax: 734-324-2981  | |
Rene Kuneman,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 19401 Northline Rd, Southgate, MI 48195 Phone: 734-785-7718  |