Organization
AFFINITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY EDWIN DOCKHAM (OWNER)
(810) 922-2569
Entity
Organization
Contact information
Practice address
1041 LINCOLN DR, BRIGHTON, MI 48116-3793
(810) 922-2569
Mailing address
1041 LINCOLN DR, BRIGHTON, MI 48116-3793
(810) 922-2569
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/03/2012
Last updated
05/14/2012
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