Individual
MICHAEL J. STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
419 TOMAHAWK DR, MAUMEE, OH 43537-1633
(419) 893-0748
(419) 891-9172
Mailing address
419 TOMAHAWK DR, MAUMEE, OH 43537-1633
(419) 893-0748
(419) 891-9172
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
LPO.120
OH
225000000X
Orthotic Fitter
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5537502
—
OH
Enumeration date
09/20/2007
Last updated
11/06/2018
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