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General NPI Number Information
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NPI Number | 1487059325
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Entity Type | Organization
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Legal Business Name | LIONS HEARING CENTER OF MICHIGAN
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 1326 ST. ANTOINE
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City | DETROIT
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State | MI
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Zip | 48226
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Country | US
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Telephone | 313-967-2048
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Fax | 313-967-2053
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Provider Business Mailing Address
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Address Line | 4201 ST. ANTOINE, 5E-UHC
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-577-5182
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Fax | 313-577-8555
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PHIL ALLEN WELLS
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Credential | MSW
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Telephone | 313-577-5182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State | MI
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