Healthcare Provider Details

I. General information

NPI: 1326390618
Provider Name (Legal Business Name): YPSILANTI URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 WASHTENAW RD
YPSILANTI MI
48197-2057
US

IV. Provider business mailing address

1715 WASHTENAW RD
YPSILANTI MI
48197-2057
US

V. Phone/Fax

Practice location:
  • Phone: 313-633-9062
  • Fax: 313-633-9062
Mailing address:
  • Phone: 734-544-8418
  • Fax: 734-544-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RAE ANNE JOERIN
Title or Position: BILLING MANAGER
Credential:
Phone: 313-633-9027