Organization
MIND BODY AND SOUL PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY CHAPMAN MD (PRESIDENT/CEO)
(313) 530-3452
Entity
Organization
Contact information
Practice address
25882 ORCHARD LAKE RD, SUITE L-5A, FARMINGTON HILLS, MI 48336-1292
(313) 530-3452
Mailing address
23744 CORA AVE, FARMINGTON HILLS, MI 48336-2620
(313) 530-3452
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301076878
MI
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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