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Organization
LIFE- ALYSIS KIDNEY CENTER, LLC
Active
Organization
LIFE- ALYSIS KIDNEY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LYLE MARUICE GRAY (PARTNER)
(313) 371-5433
Entity
Organization
Contact information
Practice address
5830 CONNER ST, DETROIT, MI 48213-3458
(313) 371-5433
(313) 371-6937
Mailing address
5830 CONNER ST, DETROIT, MI 48213-3458
(313) 371-5433
(313) 371-6937
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
302R00000X
MI
Other
Enumeration date
08/31/2006
Last updated
01/23/2013
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