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Organization
GLORY VISITING PHYSICIAN PC.
Active
Organization
GLORY VISITING PHYSICIAN PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARISE LANETTE VALENTINE M. D. (NEUROLOGIST)
(248) 569-5476
Entity
Organization
Contact information
Practice address
4245 S BEECH DALY ST, DEARBORN HTS, MI 48125-1567
(248) 569-5476
(248) 424-8987
Mailing address
30063 RAMBLING RD, SOUTHFIELD, MI 48076-1038
(248) 569-5476
(248) 424-8987
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
4301053752
MI
Other
Enumeration date
07/18/2007
Last updated
06/08/2015
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