| NPI | 1104106020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD AMBROSE President 734-425-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901001007) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2011-08-23 |