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General NPI Number Information
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NPI Number | 1700378437
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Entity Type | Organization
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Legal Business Name | TALEM TECHNOLOGIES LLC
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 400 RENAISSANCE CTR STE 2900
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City | DETROIT
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State | MI
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Zip | 48243-1602
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Country | US
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Telephone | 313-262-3370
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Fax |
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Provider Business Mailing Address
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Address Line | 400 RENAISSANCE CTR STE 2900
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City | DETROIT
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State | MI
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Zip | 48243-1602
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Country | US
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Telephone | 313-262-3370
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BLAKE MATHIE
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Credential |
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Telephone | 313-748-7534
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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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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 |
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