Organization
NORTHWEST INDUSTRIAL DRUG REHABILITATION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL DENNIS FOWLER M.D. (OWNER PRESIDENT)
(313) 894-4879
Entity
Organization
Contact information
Practice address
9600 DEXTER AVE, DETROIT, MI 48206-1816
(313) 894-6379
Mailing address
9600 DEXTER AVE, DETROIT, MI 48206-1816
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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