| NPI | 1902955560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES M. JOHNSON Director/Owner 313-862-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI cj001211) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-05-13 |