Organization
HACKLEY ORTHOTICS & PROSTHETICS
Active
Other names
Lakeshore Orthotics & Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD MICHAEL LUNSFORD CO (DIRECTOR)
(231) 739-2217
Entity
Organization
Contact information
Practice address
1887 E SHERMAN BLVD, MUSKEGON, MI 49444-1859
(231) 739-2217
(231) 737-6119
Mailing address
1887 E SHERMAN BLVD, MUSKEGON, MI 49444-1859
(231) 739-2217
(231) 737-6119
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
530F10776
BCBS
MI
Enumeration date
09/07/2005
Last updated
08/22/2020
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