Organization
GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER
Active
Other names
Great Lakes Prosthetics and Orthotics LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER JAMES FAIRMAN CPO (CO-OWNER)
(734) 528-5200
Entity
Organization
Contact information
Practice address
5315 ELLIOTT DR, SUITE 104, YPSILANTI, MI 48197-8634
(734) 528-5200
(734) 528-5260
Mailing address
5315 ELLIOTT DR, SUITE 104, YPSILANTI, MI 48197-8634
(734) 528-5200
(734) 528-5260
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/28/2011
Last updated
04/01/2011
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