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NPI Code Detail

MEDICARE: LEELANAU FOOT AND ANKLE CENTER, P.C.

MEDICARE: LEELANAU FOOT AND ANKLE CENTER, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP1100XPodiatric Clinic/Center5901002556MI

General Provider Information

NPI Number : 1770931818
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEELANAU FOOT AND ANKLE CENTER, P.C.
Provider Business Mailing Address
First Line : 718 N SAINT JOSEPH ST
Second Line : UNIT K-1
City : SUTTONS BAY
State : MI
Zip : 49682-8422
Country : US
Telephone Number : 231-866-4406
Fax Number : 231-866-4408
Provider Business Practice Location Address
First Line : 718 N SAINT JOSEPH ST
Second Line : UNIT K-1
City : SUTTONS BAY
State : MI
Zip : 49682-8422
Country : US
Telephone Number : 231-866-4406
Fax Number : 231-866-4408
Authorized Official
Title or Position : OWNER/ PODIATRIST
Name : DR. SARAH DANIELLE MILLER
Credential : D.P.M.
Telephone Number : 231-866-4406
Provider Enumeration Date : 05/31/2016
Last Update Date : 12/28/2016

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