Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5901001396 | MI |
Y | 222Z00000X | Podiatrist | 5901001396 | MI |
NPI | 1033158225 |
---|---|
Provider Name | Judi Ecker |
First Address | Saginaw, MI 48603-2433 |
Second Address | Essexville, MI 48732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T91703 | (02) | MI |