Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Emmendorfer

Individual provider Occupational Therapy Assistant · NPI 1427831247

Jack Emmendorfer is an Occupational Therapy Assistant in Chesterfield, Michigan. Licensed in Michigan. Registered with an NPI since 2023.

Licensed in
MI
In the registry since
2023
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Practice location Address checks out

33875 Kiely Dr
Chesterfield, MI 48047-3604
Phone: (586) 725-6030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5202010112 (MI)

Record details

NPI number1427831247
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 15, 2023
Last updated in NPPESAugust 15, 2023
Certification dateAugust 15, 2023
Mailing address53206 Mark Dr, Shelby Township, MI 48316-2371

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