Organization
INDEPENDENT CARE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KENQUILLIA NELSON-WARE (OFFICE MANAGER)
(313) 657-4176
Entity
Organization
Contact information
Practice address
18161 W 13 MILE RD, SOUTHFIELD, MI 48076-1113
(248) 480-4183
(248) 792-2631
Mailing address
18161 W 13 MILE RD, SOUTHFIELD, MI 48076-1113
(248) 480-4183
(248) 792-2631
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
03/19/2021
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