Organization
MICHAEL'S ORTHOTICS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. T. MICHAEL KUKOWSKY C. PED. (CERTIFIED PEDORTHISTS)
(314) 532-5462
Entity
Organization
Contact information
Practice address
1551 CLASSEN DR, BELLEVILLE, IL 62220-3260
(314) 532-5462
Mailing address
225 S MERAMEC AVE, SUITE306, SAINT LOUIS, MO 63105-3511
(314) 532-5462
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
330348306
MO
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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