Organization
THE WATERFORD PARTNERS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM L CARPENTER JR. (BOARD MANAGER)
(317) 621-7475
Entity
Organization
Contact information
Practice address
5220 HIGHLAND RD, SUITE 100, WATERFORD, MI 48327-1913
(248) 461-2800
Mailing address
5220 HIGHLAND RD, SUITE 100, WATERFORD, MI 48327-1913
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
636931
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
636931
MI STATE LICENSE NUMBER
MI
Enumeration date
12/28/2006
Last updated
12/14/2007
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