| NPI | 1255669792 |
|---|---|
| Other Name | MOBILE WELLNESS |
| Entity Type | Organization |
| Authorized Contact | DENISE BRADFORD HENRY Director 248-792-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MI 5901001148) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 5901001148) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-12-30 |