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General NPI Number Information
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NPI Number | 1336362383
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Entity Type | Organization
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Legal Business Name | GUNDERSEN AND ZUKER PTR
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 8747 FERRY ST
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City | MONTAGUE
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State | MI
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Zip | 49437-2207
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Country | US
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Telephone | 231-893-5671
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Fax | 231-893-7585
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Provider Business Mailing Address
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Address Line | 8747 FERRY ST
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City | MONTAGUE
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State | MI
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Zip | 49437-2207
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Country | US
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Telephone | 231-893-5671
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Fax | 231-893-7585
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Authorized Official
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Title or Position | ACCOUNT SPECIALIST
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Name | ELIZABETH FURTAW
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Credential |
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Telephone | 231-722-3556
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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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