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General NPI Number Information
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NPI Number | 1154829984
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Entity Type | Organization
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Legal Business Name | TOP PERFORMANCE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 22815 HILLOCK AVE
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City | WARREN
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State | MI
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Zip | 48089-5418
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Country | US
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Telephone | 313-888-0754
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Fax | 313-447-2422
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Provider Business Mailing Address
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Address Line | PO BOX 470
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City | SOUTHFIELD
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State | MI
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Zip | 48037-0470
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Country | US
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Telephone | 313-888-0754
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Fax | 313-447-2422
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Authorized Official
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Title or Position | CEO
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Name | KRISTINA BROWDER
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Credential |
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Telephone | 313-888-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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