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General NPI Number Information
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NPI Number | 1588663215
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Entity Type | Organization
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Legal Business Name | GREATER LANSING ORTHOTIC CLINIC INC.
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 200 N. HOMER SUITE C
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City | LANSING
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State | MI
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Zip | 48912
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Country | US
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Telephone | 517-337-0300
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Fax | 517-337-2262
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Provider Business Mailing Address
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Address Line | 200 N. HOMER SUITE C
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City | LANSING
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State | MI
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Zip | 48912
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Country | US
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Telephone | 517-337-0300
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Fax | 517-337-2262
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BARBARA J MILLISOR
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Credential |
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Telephone | 517-337-0300
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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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