Organization
MILLERS SHOE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ETIENNE SHOTWELL JR. C.PED (OWNER)
(517) 783-1258
Entity
Organization
Contact information
Practice address
103 W MICHIGAN AVE, JACKSON, MI 49201-1303
(517) 783-1258
(517) 783-6472
Mailing address
103 W MICHIGAN AVE, JACKSON, MI 49201-1303
(517) 783-1258
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MI
Other
Enumeration date
06/14/2007
Last updated
07/21/2022
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