Organization
GREAT LAKES HOME DOCTORS PC
Active
Other names
Patient Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUNDREY LUTSKOVSKY D.O. (OWNER)
(313) 978-2343
Entity
Organization
Contact information
Practice address
1160 VILLA CT N, WALLED LAKE, MI 48390-3376
(313) 978-2343
Mailing address
1160 VILLA CT N, WALLED LAKE, MI 48390-3376
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/14/2009
Last updated
04/15/2011
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