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General NPI Number Information
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NPI Number | 1497369953
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Entity Type | Organization
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Legal Business Name | ADVANCED SCREENING, LLC
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 29201 TELEGRAPH RD STE L-01
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1301
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Country | US
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Telephone | 810-577-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 8185 TEWKSBERRY PL
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City | GRAND BLANC
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State | MI
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Zip | 48439-9626
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Country | US
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Telephone | 810-577-1102
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. JEFFREY ROBERT RUFF
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Credential |
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Telephone | 810-577-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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