JOHN R FOW III DO PC
Agencies at Liberty Dr, Shelby Township, MI

License number
Michigan 5101005649
Category
Agencies
Type
Home Health
Owner
Name: JOHN R FOW III D.O.
Title: PRESIDENT
Phone: (586) 739-4779
Address
Address
48155 Liberty Dr, Shelby Township, MI 48315
National Provider ID: 1427282961
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JOHN R. FOW III, D.O., PC

Shelby Township, MI

Status:
Inactive
Registration:
Apr 24, 2009
Addresses:
48155 Liberty Dr, Utica, MI 48315 (Physical)
Michigan (Mailing)
State ID:
02194J
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2012
Agent:
John R. Fow, D.o

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