Individual ProviderLois Anne O'RourkePhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address973 Ottawa Ave NW, Grand Rapids, MI 49503-1431(616) 391-7752PECOS EnrollmentBased on the most recent information from CMS, provider Lois Anne O'Rourke 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 4 days ago.Profile DetailsProvider ID1043327992Provider TypeIndividualFull NameO'Rourke, Lois AnneCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date8/25/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address973 Ottawa Ave NW, Grand Rapids, MI 49503-1431Phone(616) 391-7752Fax(616) 391-7733Mailing LocationMailing Address973 Ottawa Ave NW, Grand Rapids, MI 49503-1431Phone(616) 391-7752Fax(616) 391-7733Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense5601002679Michigan