| NPI | 1013001221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY SMITH Manager 586-574-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI ZH002007) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI ck000960) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI MS00843) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI ck000960) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-08-02 |