| NPI | 1760531628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHNSON Dpm 313-862-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI cj001211) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-11-22 |