| NPI | 1679567549 |
|---|---|
| Former Legal Business Name | LAKESHORE ORTHOTICS & PROSTHETICS |
| Entity Type | Organization |
| Authorized Contact | GERALD MICHAEL LUNSFORD Director 231-739-2217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-22 |