Organization
PROVIDENCE HOSPITAL AND MEDICAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE B GORDON M.A. (AUDIOLOGIST)
(248) 849-3392
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3392
Mailing address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3392
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Enumeration date
11/02/2009
Last updated
11/18/2009
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