Organization
HENRY FORD HEALTH SYSTEM
Active
Organization
HENRY FORD HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY LEISE PACK MD (ORTHOPAEDIC SURGEON)
(810) 348-7907
Entity
Organization
Contact information
Practice address
2333 BIDDLE AVENUE, HENRY FORD WYANDOTTE HOSPITAL, WYANDOTTE, MI 48192
(734) 246-6036
Mailing address
2333 BIDDLE AVE., HENRY FORD WYANDOTTE HOSPITAL, WYANDOTTE, MI 48192-9552
(734) 246-6036
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
43010335400
MI
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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