Organization
MYSTIC MEDICAL EQUIPMENT INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN FLEESON (BILLING MANAGER)
(248) 476-8811
Entity
Organization
Contact information
Practice address
20467 MACK AVE, GROSSE POINTE WOODS, MI 48236-1654
(313) 347-8811
Mailing address
PO BOX 250843, WEST BLOOMFIELD, MI 48325-0843
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Enumeration date
01/21/2008
Last updated
08/15/2011
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