TRI COUNTY MD PC
Marriage and Family Therapists in Hazel Park, MI

License number
Michigan TD062122
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DR. THULASI DIVI MD
Title: OWNER
Phone: (248) 541-1114
Address
Address
624 Mile Rd, Hazel Park, MI 48030
National Provider ID: 1992071070
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TRI COUNTY MD PC

Hazel Park, MI  -  Detroit, MI

Registration:
Mar 15, 2012
Addresses:
624 E 9 Mile Rd, Hazel Park, MI 48030 (Physical)
670 S Oxford Rd, Grosse Pointe, MI 48236 (Mailing)
State ID:
04621R
Business type:
Domestic Professional Service Corporation
Agent:
Thulasi Divi

Marriage and Family Therapists licenses in Michigan


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