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Organization
PURE OAK HEALTH SERVICES LLC
Active
Organization
PURE OAK HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHATERRI DIXON (ADMINISTRATION)
(248) 677-4061
Entity
Organization
Contact information
Practice address
23300 GREENFIELD RD STE 105, OAK PARK, MI 48237-8407
(248) 677-4061
(248) 677-4063
Mailing address
23300 GREENFIELD RD STE 105, OAK PARK, MI 48237-8407
(248) 677-4061
(248) 677-4063
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
05/13/2019
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