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NPI Code Detail

MEDICARE: TONIA GLADNEY

MEDICARE: TONIA GLADNEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator472753978MI

General Provider Information

NPI Number : 1568840114
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONIA GLADNEY
Provider Business Mailing Address
First Line : 18495 MICHAEL AVE
Second Line :
City : EASTPOINTE
State : MI
Zip : 48021-1333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19211 ANGLIN ST
Second Line :
City : DETROIT
State : MI
Zip : 48234-1460
Country : US
Telephone Number : 313-263-0077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2015
Last Update Date : 05/15/2018

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Directions to “ TONIA GLADNEY ” Practice Location

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