Organization
DIGITAL FOOT LAB USA , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHASHIKANT NAGLE C.P. (PRESIDENT)
(586) 200-5870
Entity
Organization
Contact information
Practice address
21020 KELLY RD, EASTPOINTE, MI 48021-3126
(586) 200-5870
Mailing address
1740 W BIG BEAVER RD, SUITE 102, TROY, MI 48084-3507
(248) 885-8302
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4186896 (TYPE: 85)
—
MI
01
—
P32182F
BLUE CARE NETWORK
MI
Enumeration date
07/20/2005
Last updated
07/21/2022
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