Organization
BOARDERS MULTISPECIALTY & PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY BANKS (OWNER)
(313) 510-8861
Entity
Organization
Contact information
Practice address
24423 SOUTHFIELD RD STE 120, SOUTHFIELD, MI 48075-2864
(313) 510-8861
Mailing address
PO BOX 35, SOUTHFIELD, MI 48037-0035
(313) 510-8861
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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