# ADVANCED THERAPEUTIC MEDICAL SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063735934
- **Authorized official:** DR. OTIS CRAWFORD DO (OWNER)
- **Authorized official phone:** (313) 837-0560

## Contact information

- **Practice address:** 20905 GREENFIELD RD, SUITE 205M, SOUTHFIELD, MI 48075-5360
- **Practice address phone:** (313) 837-0560
- **Mailing address:** PO BOX 760128, LATHRUP VILLAGE, MI 48076-0128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2010
- **Last updated:** 03/08/2010