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General NPI Number Information
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NPI Number | 1326183534
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Entity Type | Organization
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Legal Business Name | ROSENBERG LIFE CENTER, INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 989 UNIVERSITY DR STE. 108
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City | PONTIAC
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State | MI
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Zip | 48342-1885
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Country | US
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Telephone | 248-364-0300
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Fax | 248-364-0301
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Provider Business Mailing Address
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Address Line | 989 UNIVERSITY DR STE. 108
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City | PONTIAC
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State | MI
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Zip | 48342-1885
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Country | US
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Telephone | 248-364-0300
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Fax | 248-364-0301
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Authorized Official
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Title or Position | OWNER
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Name | BRET GOLZBEIN
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Credential |
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Telephone | 248-364-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MI
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