Organization
ADVANCED SLEEP DISORDER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH J PHILLIPS (MANAGER)
(248) 851-1264
Entity
Organization
Contact information
Practice address
1159 E MICHIGAN AVE, SUITE D, YPSILANTI, MI 48198-5807
(734) 480-4250
(734) 480-4251
Mailing address
PO BOX 250681, FRANKLIN, MI 48025-0681
(248) 851-1264
(248) 851-5096
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
GA405226
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4618122
—
MI
Enumeration date
12/01/2006
Last updated
08/22/2020
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