Organization
PROSTHETIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD W. JUNTTONEN C.P. (PRESIDENT)
(517) 372-7007
Entity
Organization
Contact information
Practice address
1200 S WASHINGTON AVE, LANSING, MI 48910-1651
(517) 372-7007
(517) 372-0261
Mailing address
1200 S WASHINGTON AVE, LANSING, MI 48910-1651
(517) 372-7007
(517) 372-0261
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1904003
—
MI
01
—
520C303120
BLUE CROSS
MI
01
—
52547
NORTHWOOD/NPN
MI
01
—
650
NORTHWOOD
MI
01
—
P58725
BLUE CHOIC
MI
Enumeration date
08/15/2005
Last updated
03/29/2011
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