Provider Demographics
NPI:1225418411
Name:ALTIZER, JOSEPH
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:ALTIZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S EDGEWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-4061
Mailing Address - Country:US
Mailing Address - Phone:734-365-1164
Mailing Address - Fax:
Practice Address - Street 1:32 N WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2662
Practice Address - Country:US
Practice Address - Phone:734-365-1164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other