EMANUEL T. VANBOLDEN, PHD, LP, PC
Agencies at Farnsworth St, Detroit, MI

License number
Michigan 6301013909
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: DR. EMANUEL T. VANBOLDEN PHD
Title: OWNER
Phone: (248) 333-1083
Address
Address 2
60 Farnsworth St, Detroit, MI 48202
42335 Woodward Ave, Bloomfield, MI 48304
National Provider ID: 1013217660
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EMANUEL T. VANBOLDEN PHD, LP, PC

West Bloomfield, MI  -  Bloomfield, MI

Registration:
Apr 15, 2010
Addresses:
2961 Peterboro, West Bloomfield, MI 48323 (Physical)
PO Box 7254, Bloomfield Hills, MI 48302 (Mailing)
State ID:
02923G
Business type:
Domestic Professional Service Corporation
Agent:
Emanuel T Vanbolden

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