Organization
LAKER PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN PAUL TAYLOR CP (OWNER)
(616) 490-8564
Entity
Organization
Contact information
Practice address
5181 PLAINFIELD AVE NE, SUITE D, GRAND RAPIDS, MI 49525
(616) 490-8564
(616) 469-2962
Mailing address
5181 PLAINFIELD AVE NE, SUITE D, GRAND RAPIDS, MI 49525
(616) 490-8564
(616) 469-2962
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP03634
ABC
—
Enumeration date
01/03/2019
Last updated
07/15/2019
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