Provider Demographics
NPI:1770931818
Name:LEELANAU FOOT AND ANKLE CENTER, P.C.
Entity type:Organization
Organization Name:LEELANAU FOOT AND ANKLE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:231-866-4406
Mailing Address - Street 1:718 N SAINT JOSEPH ST
Mailing Address - Street 2:UNIT K-1
Mailing Address - City:SUTTONS BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49682-8422
Mailing Address - Country:US
Mailing Address - Phone:231-866-4406
Mailing Address - Fax:231-866-4408
Practice Address - Street 1:718 N SAINT JOSEPH ST
Practice Address - Street 2:UNIT K-1
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-8422
Practice Address - Country:US
Practice Address - Phone:231-866-4406
Practice Address - Fax:231-866-4408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002556261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric