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General NPI Number Information
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NPI Number | 1831586346
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Entity Type | Organization
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Legal Business Name | MICHIGAN SLEEP SOCIETY
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | G3285 BEECHER RD
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City | FLINT
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State | MI
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Zip | 48532-3615
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Country | US
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Telephone | 810-733-8338
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Fax |
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Provider Business Mailing Address
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Address Line | G3285 BEECHER RD SUITE M
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City | FLINT
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State | MI
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Zip | 48532-3615
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Country | US
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Telephone | 810-733-8338
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | MISS SOMMER CAMILLE GREEN
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Credential | MPA
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Telephone | 810-733-8338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 71169X
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License Number State | MI
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