Organization
PANAGIA MEDICAL RECOVERY CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRA GRACE MD (MEMBER)
(248) 810-4727
Entity
Organization
Contact information
Practice address
43191 DALCOMA DR STE 101, CLINTON TOWNSHIP, MI 48038-6308
(248) 810-4727
(248) 810-4727
Mailing address
43191 DALCOMA DR STE 101, CLINTON TOWNSHIP, MI 48038-6308
(248) 810-4727
(248) 810-4727
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
03/24/2026
Last updated
05/05/2026
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