Organization
KEELA YOUNT, INC.
Active
Other names
Mid-Michigan Pedorthic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KEELA YOUNT CERTIFIED PEDORTHIST (OWNER)
(517) 351-2688
Entity
Organization
Contact information
Practice address
4500 S HAGADORN RD, EAST LANSING, MI 48823-6813
(517) 351-2688
(517) 351-4770
Mailing address
4500 S HAGADORN RD, EAST LANSING, MI 48823-6813
(517) 351-2688
(517) 351-4770
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C313020
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
06/26/2008
Last updated
06/26/2008
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