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Organization
MOBIL VISITING PROFESSIONAL, INC.
Active
Organization
MOBIL VISITING PROFESSIONAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERIC LIGHT (CEO)
(248) 799-0870
Entity
Organization
Contact information
Practice address
21415 CIVIC CENTER DR, SUITE 212, SOUTHFIELD, MI 48076-3909
(248) 799-0870
(248) 799-0871
Mailing address
21415 CIVIC CENTER DR, SUITE 212, SOUTHFIELD, MI 48076-3909
(248) 799-0870
(248) 799-0871
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PENDING
MI
Other
Enumeration date
10/18/2006
Last updated
05/06/2008
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