| NPI | 1265535413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L WOLVERTON Business Manager 231-773-4509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |