Organization
TYRONE CHATMAN ETAL PTR MARTRILLA ROSS GEN PTR
Active
Other names
ACUPUNCTURE TREATMENT CONCEPTS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTRILLA MARIE ROSS-CHATMAN RN (ADMINISTRATOR)
(313) 871-9940
Entity
Organization
Contact information
Practice address
17650 W 12 MILE RD, SOUTHFIELD, MI 48076-1911
(313) 871-9940
Mailing address
17650 W 12 MILE RD, SOUTHFIELD, MI 48076-1911
(313) 871-9940
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301039079
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851583215
NPI
MI
01
—
1891701884
NPI
MI
01
—
OM83260
MEDICARE
MI
Enumeration date
08/09/2007
Last updated
08/21/2007
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