Provider Demographics
NPI:1659818755
Name:VILMINOT PROSTHETICS CLINIC
Entity type:Organization
Organization Name:VILMINOT PROSTHETICS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAINNON
Authorized Official - Middle Name:D
Authorized Official - Last Name:VILMINOT
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:517-295-4250
Mailing Address - Street 1:3469 E GRAND RIVER AVE
Mailing Address - Street 2:SUITE #110
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8504
Mailing Address - Country:US
Mailing Address - Phone:517-295-4250
Mailing Address - Fax:517-295-4276
Practice Address - Street 1:3469 E GRAND RIVER AVE
Practice Address - Street 2:SUITE #110
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8504
Practice Address - Country:US
Practice Address - Phone:517-295-4250
Practice Address - Fax:517-295-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier