Individual
TITO TIMMONS BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19309 GREENFIELD RD, DETROIT, MI 48235-2004
(313) 300-7177
Mailing address
25681 CODE RD, SOUTHFIELD, MI 48033-5813
(313) 300-7177
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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