# JOHN R FOW III DO PC

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

## Provider details

- **NPI number:** 1427282961
- **Authorized official:** JOHN R FOW III D.O. (PRESIDENT)
- **Authorized official phone:** (586) 739-4779

## Contact information

- **Practice address:** 48155 LIBERTY DR, SHELBY TOWNSHIP, MI 48315-4061
- **Practice address phone:** (586) 739-4779
- **Mailing address:** 48155 LIBERTY DR, SHELBY TOWNSHIP, MI 48315-4061
- **Mailing address phone:** (586) 739-4779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 5101005649 | MI | Yes |

## Other

- **Enumeration date:** 05/12/2009
- **Last updated:** 05/12/2009