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General NPI Number Information
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NPI Number | 1043540784
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Entity Type | Organization
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Legal Business Name | IPGDX, LLC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 705 S LAKE HURON SHORE DR
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City | HARRISVILLE
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State | MI
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Zip | 48740-9593
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Country | US
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Telephone | 989-724-5631
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 253
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City | HARRISVILLE
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State | MI
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Zip | 48740-0253
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR MANAGING MEMBER
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Name | MICHAEAL G SINGER
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Credential | PA-C
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Telephone | 989-724-5631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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