Individual
TED GLOSTER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2436 HAZELWOOD ST, DETROIT, MI 48206-2244
(313) 346-3761
Mailing address
2436 HAZELWOOD ST, DETROIT, MI 48206-2244
(313) 346-3761
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
G423789004993
MI
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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