Organization
LAKE MI MOBILE DOCTORS, P.C.
Active
Organization
LAKE MI MOBILE DOCTORS, P.C.
Active
Other names
Mobile Doctors of Detroit Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSYN CONTRERAS (DIRECTOR, QUALITY ASSURANCE)
(773) 751-7200
Entity
Organization
Contact information
Practice address
24445 NORTHWESTERN HWY, SUITE #206, SOUTHFIELD, MI 48075-6501
(248) 799-0086
(248) 350-1178
Mailing address
3319 N ELSTON AVE, SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4401
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
11/07/2006
Last updated
10/09/2012
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