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General NPI Number Information
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NPI Number | 1770104994
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Entity Type | Organization
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Legal Business Name | PRECISION PODIATRY PLLC
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 917 N LAFAYETTE ST
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City | GREENVILLE
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State | MI
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Zip | 48838-1129
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Country | US
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Telephone | 616-754-9580
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Fax | 616-754-9519
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Provider Business Mailing Address
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Address Line | 917 N LAFAYETTE ST
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City | GREENVILLE
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State | MI
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Zip | 48838-1129
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Country | US
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Telephone | 616-754-9580
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Fax | 616-754-9519
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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 | 313-203-6002
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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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