Organization
FRANK DEUTSCH CORPORATION
Active
Other names
Modern Shoe Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY LEE MICHEL C PED (PRESIDENT)
(815) 284-3007
Entity
Organization
Contact information
Practice address
1309 N GALENA AVE, SUITE 110, DIXON, IL 61021-1060
(815) 284-3007
(815) 284-3007
Mailing address
1309 N GALENA AVE, SUITE 110, DIXON, IL 61021-1060
(815) 284-3007
(815) 284-3007
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
IL
Other
Enumeration date
01/02/2007
Last updated
08/22/2020
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