GLORY VISITING PHYSICIAN PC.
Residential Treatment Facilities at Beech Daly St, Dearborn Heights, MI

License number
Michigan 4301053752
Category
Residential Treatment Facilities
Type
Residential Treatment Facility, Physical Disabilities
Owner
Name: DR. CHARISE LANETTE VALENTINE M. D.
Title: NEUROLOGIST
Phone: (248) 569-5476
Address
Address 2
4245 S Beech Daly St, Dearborn Heights, MI 48125
30063 Rambling Rd, Southfield, MI 48076
National Provider ID: 1669672705
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GLORY VISITING PHYSICIAN PC

Dearborn Heights, MI

Status:
Inactive
Registration:
Nov 30, 2007
Addresses:
4245 Beechdale, Dearborn Heights, MI 48125 (Physical)
Michigan (Mailing)
State ID:
01312V
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2010
Agent:
Charise L Valentine

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