Organization
CHOCTAW MANAGEMENT SERVICES ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY HUMPHREY (PROGRAM COORDINATOR)
(877) 267-3728
Entity
Organization
Contact information
Practice address
1172 KIRTS BLVD, U.S. MEPS, TROY, MI 48084-4846
(248) 244-9131
Mailing address
2773 MAYFAIR DR, TROY, MI 48084-2601
(248) 649-1042
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
4301037778
MI
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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