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General NPI Number Information
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NPI Number | 1639315112
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Entity Type | Organization
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Legal Business Name | MIOTECH ORTHOPEDIC SALES, LLC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 4125 OKEMOS RD SUITE 22
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City | OKEMOS
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State | MI
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Zip | 48864-2819
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Country | US
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Telephone | 517-347-0220
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Fax | 517-347-0221
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Provider Business Mailing Address
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Address Line | 4125 OKEMOS RD SUITE 22
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City | OKEMOS
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State | MI
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Zip | 48864-2819
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Country | US
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Telephone | 517-347-0220
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Fax | 517-347-0221
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Authorized Official
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Title or Position | CEO
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Name | MR. KENNETH MICHAEL ZISHOLZ
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Credential |
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Telephone | 517-347-0220
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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 | MI
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