| NPI | 1609057470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A BODO Medical Biller 248-693-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI ja400164) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2015-01-02 |