Organization
MILTON J GROSENBACH EDD, PC
Active
Other names
The Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILTON JAMES GROSENBACH JR. EDD PC (DR OWNER)
(810) 678-8898
Entity
Organization
Contact information
Practice address
3562 S LAPEER RD, SUITE F, METAMORA, MI 48455-8998
(810) 678-8898
(810) 678-8808
Mailing address
3562 S LAPEER RD, SUITE F, METAMORA, MI 48455-8998
(810) 678-8898
(810) 678-8808
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301003782
MI
302F00000X
Exclusive Provider Organization
4101005216
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D41076
BLUE CROSS BLUE SHIELD
MI
01
—
0M43200
MEDICARE ID
MI
01
—
620G44601
HEALTH PLUS
MI
01
—
OD41119
BLUE CARE NETWORK
MI
Enumeration date
01/31/2007
Last updated
06/27/2016
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