Organization
EDWARD J. LIS, JR, DO, PLLC
Active
Organization
EDWARD J. LIS, JR, DO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREL A WISNIEWSKI CPC (CREDENTIALING/CODING)
(248) 872-8001
Entity
Organization
Contact information
Practice address
17200 SILVER PKWY, FENTON, MI 48430-4437
(248) 872-8001
(248) 872-8001
Mailing address
PO BOX 1855, CLARKSTON, MI 48347-1855
(248) 872-8001
(248) 673-8079
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101014456
MI
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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