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General NPI Number Information
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NPI Number | 1043395262
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Entity Type | Organization
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Legal Business Name | MT CLEMENS ORTHOPAEDIC APPLIANCES INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 24432 CROCKER BLVD
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City | CLINTON TWP
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State | MI
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Zip | 48036
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Country | US
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Telephone | 586-463-3600
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Fax | 586-463-6337
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Provider Business Mailing Address
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Address Line | 24432 CROCKER BLVD
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City | CLINTON TWP
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State | MI
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Zip | 48036
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Country | US
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Telephone | 586-463-3600
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Fax | 586-463-6337
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROLF M SCHROETER
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Credential | CO
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Telephone | 586-463-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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