EXCEL FOOTCARE
Podiatry at Fordham St, Sylvan Lake, MI

License number
Michigan 5901002140
Category
Podiatry
Type
Podiatrist
Owner
Name: DR. CHANTALE E BOTHUELL D.P.M.
Title: CEO
Phone: (313) 384-7300
Address
Address
2424 Fordham St, Sylvan Lake, MI 48320
National Provider ID: 1912229105
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EXCEL FOOTCARE, PC

Sylvan Lake, MI  -  West Bloomfield, MI

Industry:
Podiatrist's Office
Registration:
Feb 5, 2010
Addresses:
2424 Fordham St, Keego Harbor, MI 48320 (Physical)
Michigan (Mailing)
5582 Hobnail Cir, West Bloomfield, MI 48322
State ID:
03023G
Business type:
Domestic Professional Service Corporation
Chief Executive Officer, Podiatrist, Principal:
Chantale Bothuell (Chief Executive Officer, Podiatrist, Principal)
Agent:
Chantale E Bothuell

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