| NPI | 1114097474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D NIEMELA Physician Owner 906-225-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002208) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 5901002208) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2017-03-03 |