NPI | 1508004920 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN GEORGE LODER Owner 586-329-3895 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901001662) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2009-01-22 |
Last Update Date | 2022-11-02 |