Organization
CLINTON RIVER AFFILIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT LUKE SANSOVICH (PRESIDENT)
(985) 789-2534
Entity
Organization
Contact information
Practice address
31547 W 13 MILE RD, FARMINGTON HILLS, MI 48334-2103
(985) 789-2534
Mailing address
31547 W 13 MILE RD, FARMINGTON HILLS, MI 48334-2103
(985) 789-2534
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/04/2017
Last updated
07/21/2022
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