| NPI | 1710959150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JACOT Business Administrator 810-732-1620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-12-20 |