| NPI | 1699076455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CAROLLO Owner 586-298-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MI 5901002345) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2016-04-04 |