Healthcare Provider Details

I. General information

NPI: 1356465751
Provider Name (Legal Business Name): LYTLE MEDICAL TECHNOLOGIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34119 W 12 MILE RD STE 130
FARMINGTON HILLS MI
48331
US

IV. Provider business mailing address

33228 W 12 MILE RD # 327
FARMINGTON HILLS MI
48334-3309
US

V. Phone/Fax

Practice location:
  • Phone: 248-626-3100
  • Fax: 248-626-3113
Mailing address:
  • Phone: 248-626-3100
  • Fax: 248-626-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PATRICK DAVIDSON
Title or Position: CEO
Credential:
Phone: 248-626-3100