Individual
ANTHONY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11068 CLOVERLAWN ST, DETROIT, MI 48204-1072
(313) 931-0107
(313) 931-0318
Mailing address
11068 CLOVERLAWN ST, DETROIT, MI 48204-1072
(313) 931-0107
(313) 931-0318
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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