Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5901002734 | MI |
Y | 222Z00000X | Podiatrist | 5901002734 | MI |
NPI | 1043703176 |
---|---|
Provider Name | Dr. David C Vance |
First Address | Grand Blanc, MI 48439-8065 |
Second Address | Grand Blanc, MI 48439-8065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2018 |
Last Update Date | 13/06/2018 |