Healthcare Provider Details

I. General information

NPI: 1144934175
Provider Name (Legal Business Name): VHA MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S INDUSTRIAL HWY STE 300
ANN ARBOR MI
48104-6233
US

IV. Provider business mailing address

2725 S INDUSTRIAL HWY STE 300
ANN ARBOR MI
48104-6233
US

V. Phone/Fax

Practice location:
  • Phone: 866-307-5773
  • Fax:
Mailing address:
  • Phone: 866-307-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRACE
Title or Position: MAJORITY STOCKHOLDER
Credential:
Phone: 480-244-7094