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General NPI Number Information
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NPI Number | 1255008207
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Entity Type | Individual
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Provider Name | ROSLYN L FRAZIER REED MEDICAL PROSTHESIC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 39500 W 10 MILE RD STE 105
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City | NOVI
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State | MI
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Zip | 48375-2947
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Country | US
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Telephone | 248-719-4778
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Fax | 248-793-9926
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Provider Business Mailing Address
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Address Line | 39500 W 10 MILE RD STE 105
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City | NOVI
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State | MI
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Zip | 48375-2947
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Country | US
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Telephone | 248-719-4778
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Fax | 248-793-9926
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State | MI
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Taxonomy #2
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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 | MI
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