| NPI | 1144453770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALAN WASIAK President 248-478-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901000651) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |