Organization
MEDISTAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORTHIA CAROLYN GLOVER CCEMT-P (PARAMEDIC/MEDICAL ASSISTANT)
(734) 587-2217
Entity
Organization
Contact information
Practice address
8511 OAKVILLE WALTZ RD, BELLEVILLE, MI 48111-9504
(248) 914-6015
Mailing address
8511 OAKVILLE WALTZ RD, BELLEVILLE, MI 48111-9504
(248) 914-6015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3201006614
MI
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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