Organization
SENIORS WELLNESS GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY MICHAEL KOTLARZ PH.D. (OWNER)
(248) 398-6459
Entity
Organization
Contact information
Practice address
221 S MAIN ST, SUITE 201, ROYAL OAK, MI 48067-2611
(248) 398-6459
Mailing address
221 S MAIN ST, SUITE 201, ROYAL OAK, MI 48067-2611
(248) 398-6459
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/28/2006
Last updated
07/08/2022
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