Organization
ST JOHN DYNAMIC SPINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY MCDONALD (VICE PRESIDENT)
(248) 649-2323
Entity
Organization
Contact information
Practice address
31700 VAN DYKE AVE, SUITE 160, WARREN, MI 48093-7949
(248) 649-2323
(248) 649-5998
Mailing address
1800 W BIG BEAVER RD, SUITE 150, TROY, MI 48084-3545
(248) 649-2323
(248) 649-5998
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/25/2010
Last updated
05/25/2010
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