# CONCENTRA MEDICAL CENTER -- CANTON

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OCCUPATIONAL HEALTH CENTERS OF MICHIGAN, P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114117447
- **Legal business name:** OCCUPATIONAL HEALTH CENTERS OF MICHIGAN, P.C.
- **Authorized official:** DR. W. TOM FOGARTY M.D. (CHIEF MEDICAL OFFIDER)
- **Authorized official phone:** (972) 364-8000

## Contact information

- **Practice address:** 1600 S CANTON CENTER RD, SUITE 140, CANTON, MI 48188-1992
- **Practice address phone:** (734) 398-7550
- **Mailing address:** PO BOX 5106, SOUTHFIELD, MI 48086-5106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2007
- **Last updated:** 08/08/2007