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General NPI Number Information
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NPI Number | 1760973911
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Entity Type | Organization
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Legal Business Name | TAILORMED MEDICAL INC
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 30100 TELEGRAPH ROAD, SUITE 403
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City | BRINGHAM FARMS
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State | MI
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Zip | 48025
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Country | US
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Telephone | 800-910-9801
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Fax |
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Provider Business Mailing Address
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Address Line | 30100 TELEGRAPH ROAD, SUITE 403
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City | BRINGHAM FARMS
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State | MI
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Zip | 48025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ISRAEL DVORSKY
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Credential |
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Telephone | 800-910-9801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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