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General NPI Number Information
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NPI Number | 1659569796
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Entity Type | Organization
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Legal Business Name | INFUSAL DIRECT, INC.
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 8315 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48204-2231
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Country | US
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Telephone | 313-361-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 8315 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48204-2231
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Country | US
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Telephone | 313-361-1030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YIPSIS OROZCO-RUIZ
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Credential |
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Telephone | 313-361-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State |
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