Organization
GODDARD CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH WILLIAM DEBYLE D.O. (PRESIDENT)
(313) 386-3960
Entity
Organization
Contact information
Practice address
17234 GODDARD RD, ALLEN PARK, MI 48101-4100
(313) 386-3960
(313) 386-0145
Mailing address
17234 GODDARD RD, ALLEN PARK, MI 48101-4100
(313) 386-3960
(313) 386-0145
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101005616
MI
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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