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Organization

OTEVWA HOMES INC

Active
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Organization

OTEVWA HOMES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIVE EVWARAYE (DIRECTOR)
(313) 690-0667
Entity
Organization

Contact information

Practice address
6556 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4956
(313) 690-0667
Mailing address
6556 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4956

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
08/29/2020
Last updated
08/29/2020
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