Organization
SPIRE 9 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAGI LEGROW (SOLE MEMBER)
(810) 691-4816
Entity
Organization
Contact information
Practice address
14799 DIX TOLEDO RD, SOUTHFIELD, MI 48033-2507
(810) 691-4816
Mailing address
12023 RIVERBEND DR, GRAND BLANC, MI 48439
(810) 691-4816
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/09/2018
Last updated
06/29/2018
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