| NPI | 1891473450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY LYNNE SIGURDSON-HOFFMANN Credentialing Specialist 248-845-4381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-01-30 |