Organization
MID MICHIGAN KETAMINE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTONIETTA ELIZABETH WALKER MHSA (PARTNER)
(810) 523-5194
Entity
Organization
Contact information
Practice address
245 E WARWICK DR, ALMA, MI 48801-1026
(313) 203-6002
Mailing address
68490 MEADOWOOD CT, WASHINGTON, MI 48095-1395
(810) 523-5194
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2022
Last updated
06/07/2022
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