Healthcare Provider Details

I. General information

NPI: 1265640700
Provider Name (Legal Business Name): ACCELERATED CARE OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 WOODSIDE AVE
ESSEXVILLE MI
48732-1234
US

IV. Provider business mailing address

6901 OKEECHOBEE BLVD BOX J17
WEST PALM BEACH FL
33411-2511
US

V. Phone/Fax

Practice location:
  • Phone: 989-892-7722
  • Fax: 989-892-7455
Mailing address:
  • Phone: 989-892-7722
  • Fax: 989-892-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1101X
TaxonomyOphthalmic Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. RAYMOND WATTS
Title or Position: PRESIDENT
Credential:
Phone: 989-892-7722