| NPI | 1407564545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA J FENN Practice Manager 248-258-0001 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-11-08 |