Organization
ADVANCED ALLERGY & ASTHMA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBA ELIZABETH JOHNSON M.D. (OWNER)
(248) 384-8310
Entity
Organization
Contact information
Practice address
5701 BOW POINTE DR, SUITE 110, CLARKSTON, MI 48346-3198
(248) 384-8310
(248) 620-5013
Mailing address
5701 BOW POINTE DR, SUITE 110, CLARKSTON, MI 48346-3198
(248) 384-8310
(248) 620-5013
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301082354
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030F381900
BCN GROUP
MI
Enumeration date
06/05/2009
Last updated
12/27/2010
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