| NPI | 1306394309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS JAMES VIELLIEU CEO 248-845-4365 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine | |
| 225100000X Physical Therapist | |
| 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2019-09-24 |