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1184801318
SOUTHFORT FAMILY CLINIC PC
SOUTHGATE, MI
NPI
1184801318
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Entity Type
Organization
Authorized Contact
EDWARD NAZARENO
President
734-281-2150
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MI 4301067719)
Enumeration Date
2008-01-30
Last Update Date
2008-01-30
Business Address
SOUTHFORT FAMILY CLINIC PC
13650 FORT ST
SOUTHGATE, MI 48195-1152
Phone number: 734-281-2150
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Mailing Address
SOUTHFORT FAMILY CLINIC PC
13650 FORT ST
SOUTHGATE, MI 48195-1152
Phone number: 734-281-2150
Copy
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