Organization
MICHIGAN ORTHOPEDIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE CONDON (PRESIDENT/CEO)
(734) 513-8205
Entity
Organization
Contact information
Practice address
15400 NORTHLINE RD., SOUTHGATE, MI 48195-2333
(734) 530-0101
(734) 530-0102
Mailing address
13450 FARMINGTON ROAD, LIVONIA, MI 48150-4207
(734) 513-8205
(734) 293-0510
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3220750
—
MI
Enumeration date
05/02/2007
Last updated
12/15/2010
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