Organization
FACILICARE CLINICAL MICHIGAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYLNELLE FEARSON (CREDENTIALING SPECIALIST)
(248) 845-4237
Entity
Organization
Contact information
Practice address
122 E BROWN ST, BIRMINGHAM, MI 48009-6201
(248) 845-4237
Mailing address
PO BOX 2137, BIRMINGHAM, MI 48012-2137
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
10/25/2024
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