| NPI | 1457789042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN A. BEATTY Owner 248-824-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ES0131X | |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2013-10-17 |