Organization
CONCENTRA MEDICAL CENTER -- CANTON
Active
Parent organization
OCCUPATIONAL HEALTH CENTERS OF MICHIGAN, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OCCUPATIONAL HEALTH CENTERS OF MICHIGAN, P.C.
Authorized official
DR. W. TOM FOGARTY M.D. (CHIEF MEDICAL OFFIDER)
(972) 364-8000
Entity
Organization
Contact information
Practice address
1600 S CANTON CENTER RD, SUITE 140, CANTON, MI 48188-1992
(734) 398-7550
Mailing address
PO BOX 5106, SOUTHFIELD, MI 48086-5106
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
08/08/2007
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