Organization
GRATIOT ADVANCED CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKEISHA WILLIAMS (OFFICE MANAGER)
(313) 924-8994
Entity
Organization
Contact information
Practice address
7612 GRATIOT AVE STE 200, DETROIT, MI 48213-2822
(313) 924-8994
(313) 924-8990
Mailing address
7612 GRATIOT AVE STE 200, DETROIT, MI 48213-2822
(313) 924-8994
(313) 924-8990
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
11/02/2018
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