Organization
SPORTS MEDICINE CENTER OF METRO DETROIT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACKIE TREMONTI (BILLER)
(248) 813-0002
Entity
Organization
Contact information
Practice address
5600 CROOKS RD, SUITE 103, TROY, MI 48098-2811
(248) 813-0002
(248) 813-0007
Mailing address
5600 CROOKS RD, SUITE 103, TROY, MI 48098-2811
(248) 813-0002
(248) 813-0007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
JC039731
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1741033
—
MI
Enumeration date
03/22/2007
Last updated
08/18/2014
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