Organization
NORTHWEST INDUSTRAIL DRUG REHABILITATION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL FOWLER MD (OWNER)
(313) 894-4879
Entity
Organization
Contact information
Practice address
9600 DEXTER AVE, DETROIT, MI 48206-1816
(313) 894-4879
(313) 894-6312
Mailing address
9600 DEXTER AVE, DETROIT, MI 48206-1816
(313) 894-4879
(313) 894-6312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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