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General NPI Number Information
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NPI Number | 1821458001
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Entity Type | Organization
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Legal Business Name | SOUTHEAST MICHIGAN FOOT AND ANKLE CLINICS PLLC
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 7575 GRAND RIVER RD STE 205
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City | BRIGHTON
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State | MI
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Zip | 48114-9379
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Country | US
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Telephone | 810-360-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 7575 GRAND RIVER RD STE 205
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City | BRIGHTON
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State | MI
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Zip | 48114-9379
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Country | US
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Telephone | 810-360-1356
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ERIN YOUNCE
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Credential | DPM
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Telephone | 810-360-1356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E7988W
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License Number State | MI
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