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1194133686
MICHIGAN MEDICAL MALL
DETROIT, MI
NPI
1194133686
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Entity Type
Organization
Authorized Contact
SCHARA DAVIS
Owner/Incorporator
256-262-9310
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2014-07-28
Last Update Date
2014-07-28
Business Address
MICHIGAN MEDICAL MALL
17350 LIVERNOIS AVE
DETROIT, MI 48221-2759
Phone number: 256-262-9310
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Mailing Address
MICHIGAN MEDICAL MALL
17350 LIVERNOIS AVE
DETROIT, MI 48221-2759
Phone number:
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