Healthcare Provider Details

I. General information

NPI: 1689692428
Provider Name (Legal Business Name): THE FURNITURE DOCTOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6282 E HOWARD CITY EDMORE RD
VESTABURG MI
48891-9424
US

IV. Provider business mailing address

PO BOX 123
CEDAR LAKE MI
48812-0123
US

V. Phone/Fax

Practice location:
  • Phone: 989-427-5646
  • Fax: 989-427-5053
Mailing address:
  • Phone: 989-427-5646
  • Fax: 989-427-5053

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: MR. DOUGLAS C GRUESBECK
Title or Position: OWNER OPERATOR
Credential:
Phone: 989-427-5646