| Ftra | |
|
217 Knowles St Suite 260 Royal Oak MI 48067-2767 | |
| (248) 760-2672 | |
| Not Available |
| Full Name | Ftra |
|---|---|
| Speciality | Social Worker |
| Location | 217 Knowles St, Royal Oak, Michigan |
| Authorized Official Name and Position | Dennis Joseph Muzzi (RESIDENT AGENT) |
| Authorized Official Contact | 2487602672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ftra 217 Knowles St Suite 260 Royal Oak MI 48067-2767 Ph: (248) 760-2672 | Ftra 217 Knowles St Suite 260 Royal Oak MI 48067-2767 Ph: (248) 760-2672 |
| NPI Number | 1407107154 |
|---|---|
| Provider Enumeration Date | 09/20/2012 |
| Last Update Date | 10/21/2016 |
| Medicare PECOS PAC ID | 3375826100 |
|---|---|
| Medicare Enrollment ID | O20170201002243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407107154 | NPI | - | NPPES |
| 1316046220 | Other | MI | NPI-1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801017027 (Michigan) | Primary |
| Provider Name | Dennis J Muzzi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316046220 PECOS PAC ID: 6305827320 Enrollment ID: I20040526000708 |
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