Organization
NILES ORTHOPEDICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MICHAEL GRANNELL D.O. (PRESIDENT)
(269) 684-3028
Entity
Organization
Contact information
Practice address
6 LONGMEADOW VILLAGE DR, SUITE 1, NILES, MI 49120-7810
(269) 684-3028
(268) 684-5291
Mailing address
6 LONGMEADOW VILLAGE DR, SUITE 1, NILES, MI 49120-7810
(269) 684-3028
(268) 684-5291
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101007545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1575040
—
MI
Enumeration date
10/10/2007
Last updated
10/10/2007
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