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General NPI Number Information
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NPI Number | 1912030974
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Entity Type | Organization
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Legal Business Name | LEONARD YOUROFSKY DPM
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 25811 W 12 MILE RD STE 205
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1896
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Country | US
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Telephone | 248-262-3443
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Fax | 248-262-3444
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Provider Business Mailing Address
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Address Line | 25811 W 12 MILE RD STE 205
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1896
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Country | US
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Telephone | 248-262-3443
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Fax | 248-262-3444
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Authorized Official
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Title or Position | OWNER
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Name | MR. LEONARD YOUROFSKY
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Credential | DPM
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Telephone | 248-262-3444
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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 | 5901000631
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License Number State | MI
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