| NPI | 1407837958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN FRASCONE Cmo 586-725-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2024-04-20 |