Organization
PODIATRY WEST SENIOR FOOT CARE SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SMITH D.P.M. (GENERAL MEMBER)
(616) 456-9744
Entity
Organization
Contact information
Practice address
56 BENJAMIN AVE SE, GRAND RAPIDS, MI 49506-1628
(616) 456-9744
(616) 451-0717
Mailing address
56 BENJAMIN AVE SE, GRAND RAPIDS, MI 49506-1628
(616) 456-9744
(616) 451-0717
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001622
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4461768
—
MI
Enumeration date
04/08/2008
Last updated
04/08/2008
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