| NPI | 1518093400 |
|---|---|
| Former Legal Business Name | MADISON PODIATRY ASSOCIATES, P C |
| Entity Type | Organization |
| Authorized Contact | BRUCE JACOB President 248-739-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MI 5901000789) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2015-08-24 |