Organization
CENTER FOR WEIGHT MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY JO GREEN R.N., BSN (PROGRAM COORDINATOR)
(586) 759-7469
Entity
Organization
Contact information
Practice address
13355 E. TEN MILE RD., SUITE CHM, WARREN, MI 48089-2065
(586) 759-7457
Mailing address
13355 E. TEN MILE RD., SUITE CHM, WARREN, MI 48089-2065
(586) 759-7457
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
VS080188
MI
Other
Enumeration date
06/04/2007
Last updated
08/29/2007
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