| NPI | 1295034593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN BEATTY Owner 248-824-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2013-03-11 |