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General NPI Number Information
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NPI Number | 1790191013
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Entity Type | Organization
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Legal Business Name | MICHIGAN INSTITUTE FOR HEALTH INHANCEMENT
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 4968 N ADAMS RD
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City | ROCHESTER
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State | MI
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Zip | 48306-1416
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Country | US
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Telephone | 248-475-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 4968 N ADAMS RD
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City | ROCHESTER
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State | MI
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Zip | 48306-1416
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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 | PHYSICIAN
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Name | ALIGRAS JUOCYS
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Credential | D.O
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Telephone | 248-475-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704278240
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License Number State | MI
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