Organization
PURPLE ARCH NEURO REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LAURIE SOUTHERN JR. SLPD (OWNER, SPEECH-LANGUAGE PATHOLOGIST)
(586) 859-9607
Entity
Organization
Contact information
Practice address
53359 CHAMPLAIN ST, MACOMB, MI 48042-3739
(586) 859-9607
Mailing address
53359 CHAMPLAIN ST, MACOMB, MI 48042-3739
(586) 859-9607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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