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General NPI Number Information
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NPI Number | 1477842862
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Entity Type | Organization
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Legal Business Name | PERMECARE
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 8139 HUMMINGBIRD CT
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City | YPSILANTI
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State | MI
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Zip | 48197-6213
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Country | US
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Telephone | 248-325-6025
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Fax | 888-502-9335
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Provider Business Mailing Address
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Address Line | 8139 HUMMINGBIRD CT
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City | YPSILANTI
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State | MI
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Zip | 48197-6213
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Country | US
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Telephone | 248-325-6025
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Fax | 888-502-9335
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTORIA DOOLEY
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Credential | MD
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Telephone | 248-709-2049
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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 | 4301090829
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License Number State | MI
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