Organization
AMEDIQUEST HEALTH SERVICES
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YVETTE A. KOUAYARA (CLINICAL MANAGER)
(313) 340-1024
Entity
Organization
Contact information
Practice address
8112 PURITAN ST, DETROIT, MI 48238-1139
(313) 340-1031
Mailing address
8112 PURITAN ST, DETROIT, MI 48238-1139
(313) 340-1031
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
5601001767
MI
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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