| NPI | 1316191679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANISHA MEHTA Physician 313-833-3090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002275) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2014-01-03 |