| NPI | 1093901795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TABAK Owner 248-628-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 5901400128) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2012-07-23 |