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General NPI Number Information
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NPI Number | 1093276602
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Entity Type | Organization
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Legal Business Name | MOBILE PHYSICIANS NETWORK OF MICHIGAN PC
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 03/27/2019
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Provider Practice Location Address
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Address Line | 1874 ENTERPRISE DR
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City | TROY
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State | MI
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Zip | 48083-1808
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Country | US
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Telephone | 419-882-5000
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Fax | 419-882-5008
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Provider Business Mailing Address
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Address Line | 5151 MAIN ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2184
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Country | US
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Telephone | 419-318-5213
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Fax | 419-882-5008
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Authorized Official
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Title or Position | CLINICAL SERVICES COORDINATOR
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Name | REBECCA LEININGER
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Credential |
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Telephone | 419-318-5213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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