Organization
TLC MICHIGAN, LLC
Active
Organization
TLC MICHIGAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG ANTILLA (VP OF FINANCE)
(734) 761-2235
Entity
Organization
Contact information
Practice address
34405 W 12 MILE RD, SUITE 154, FARMINGTON HILLS, MI 48331-3391
(248) 489-0400
Mailing address
2723 S STATE ST, SUITE 220, ANN ARBOR, MI 48104-6188
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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