Organization
COMPREHENSIVE TREATMENT CENTER P.C.
Active
Parent organization
COMPREHENSIVE TREATMENT CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMPREHENSIVE TREATMENT CENTER
Authorized official
DR. KOTHEGALA PUTTANNIAH JAGADISH M.D. (PRESIDENT)
(248) 333-9556
Entity
Organization
Contact information
Practice address
35 S JOHNSON ST, STE 2 H, PONTIAC, MI 48341-1658
(248) 333-9556
(248) 333-9556
Mailing address
35 S JOHNSON ST, STE 2 H, PONTIAC, MI 48341-1658
(248) 333-9556
(248) 333-9556
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301043330
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P61080
MEDICARE PTAN
MI
Enumeration date
06/03/2008
Last updated
11/13/2008
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