Organization
PLYMOUTH ASTHMA & ALLERGY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK W PEARL DO (PRESIDENT)
(734) 459-2255
Entity
Organization
Contact information
Practice address
9398 N LILLEY RD, PLYMOUTH, MI 48170-4610
(734) 459-2255
(734) 459-1855
Mailing address
9398 N LILLEY RD, PLYMOUTH, MI 48170-4610
(734) 459-2255
(734) 459-1855
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
5101004511
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2628611
—
MI
Enumeration date
04/04/2006
Last updated
05/26/2009
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