Organization
WYANDOTTE PHYSICIAN PRACTICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E KIBBLE (DIRECTOR)
(313) 874-3436
Entity
Organization
Contact information
Practice address
1848 BIDDLE AVE, SUITE 101, WYANDOTTE, MI 48192-3962
(734) 284-2600
(734) 284-2666
Mailing address
PO BOX 674102, DETROIT, MI 48267-0001
(800) 827-3797
(248) 553-2108
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
08/14/2008
Last updated
06/18/2009
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