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Orthopedic Sports Medicine Of Manistee PLLC

Orthopaedic Surgery in Manistee, MI. Organization (NPI-2).

NPI number1689321010
StatusActive
Last updated in NPPESMar 5, 2022

Details

NPI
1689321010
Entity type
Organization (NPI-2)
Legal business name
Orthopedic Sports Medicine Of Manistee PLLC
Organization subpart
No
Enumeration date
Mar 5, 2022
Certification date
Mar 5, 2022
Last updated
Mar 5, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery––Yes

Practice location

3234 County Line Rd W
Manistee, MI 49660-9519

Phone 917-545-0789

Mailing address

3234 County Line Rd W
Manistee, MI 49660-9519

Phone 917-545-0789

Authorized official

Mark Dangelo
Physician
9175450789

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