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1001 Military St Port Huron MI 48060-5416 | |
| (810) 985-5168 | |
| (810) 985-9011 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1001 Military St, Port Huron, Michigan |
| Authorized Official Name and Position | Robert E Gamble (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8109855168 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Military St Port Huron MI 48060-5416 Ph: (810) 985-5168 | 1001 Military St Port Huron MI 48060-5416 Ph: (810) 985-5168 |
| NPI Number | 1316116544 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316116544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 6401010728 (Michigan) | Primary |
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