| NPI | 1952323453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISSY DURGA Administrator 231-929-5734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-10-22 |