institution
Long Lake Podiatry Pc
Customized Equipment (DME) in Troy, Michigan
NPI 1326223132

Long Lake Podiatry Pc is a Customized Equipment (DME) based in Troy, MI and is specialized in Customized Equipment. Long Lake Podiatry Pc practices in Troy, MI. The NPI Number for Long Lake Podiatry Pc is 1326223132 and holds a License No. 5901001005 (Michigan).

The current practice location address for Long Lake Podiatry Pc is 2914 E Long Lake Rd, Troy, MI and can be reached out via phone at 248-528-0709 and via fax at 248-528-1807.

Location: 2914 E Long Lake Rd, Troy, MI, 48085-3780
institution
Provider Profile Details
NPI Number
1326223132
Provider Name
Long Lake Podiatry Pc
Credential
Provider Entity Type
Organization
Address
2914 E Long Lake Rd, Troy, MI, 48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
Provider Enumeration Date
12/31/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00245692 01 MI RAILROAD MEDICARE PTAN
5631470 01 MI BCROSS PIN
1634294 05 MI
89594B 01 MI HAP
0005335144 01 MI AETNA
NC025717 01 MI PPOM PROVIDER CODE
institution
Provider Business Practice Location Address Details
Address
2914 E Long Lake Rd
City
State
Zip
48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
person
Provider Business Mailing Address Details
Address
2914 E Long Lake Rd
City
State
Zip
48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
License No.
5901001005 (Michigan)
Definition
Definition to come...
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