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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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