| NPI | 1316245343 |
|---|---|
| Other Name | GREAT LAKES PROSTHETICS AND ORTHOTICS LLC |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JAMES FAIRMAN Co Owner 734-528-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-04-01 |