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NPI 1770104903

NPI 1770104903 : PRECISION PODIATRY SERVICES PLLC : ALMA, MI

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General NPI Number Information
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    NPI Number           |    1770104903
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    Entity Type          |    Organization 
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    Legal Business Name  |    PRECISION PODIATRY SERVICES PLLC 
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Dates
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    Enumeration Date     |    04/28/2020
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    Last Update Date     |    04/28/2020
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Provider Practice Location Address
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    Address Line         |    1469 MARY CT 
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    City                 |    ALMA
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    State                |    MI
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    Zip                  |    48801-1053
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    Country              |    US
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    Telephone            |    989-463-2150
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    Fax                  |    989-466-5392
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Provider Business Mailing Address
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    Address Line         |    1469 MARY CT 
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    City                 |    ALMA
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    State                |    MI
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    Zip                  |    48801-1053
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    Country              |    US
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    Telephone            |    989-463-2150
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    Fax                  |    989-466-5392
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     FADI  JAAFAR 
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    Credential           |    DPM
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    Telephone            |    313-203-6663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213EP1101X
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    Taxonomy Name        |    Primary Podiatric Medicine Podiatrist
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    License Number       |    
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    License Number State |    
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