Healthcare Provider Details

I. General information

NPI: 1093765737
Provider Name (Legal Business Name): BECKER ORTHOPEDIC APPLIANCE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19251 MACK AVE SUITE 180
GROSSE POINTE WOODS MI
48236-2893
US

IV. Provider business mailing address

PO BOX 4840
TROY MI
48099-4840
US

V. Phone/Fax

Practice location:
  • Phone: 313-640-7750
  • Fax: 313-640-7721
Mailing address:
  • Phone: 248-588-7480
  • Fax: 248-588-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM J TOUSCANY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 248-588-7480