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8273 Grand River Rd Ste 210 Brighton MI 48114-9346 | |
| (734) 223-4581 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Sports Medicine |
| Location | 8273 Grand River Rd Ste 210, Brighton, Michigan |
| Authorized Official Name and Position | Jeffrey Kutcher (NATIONAL DIRECTOR) |
| Authorized Official Contact | 7342234581 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8273 Grand River Rd Ste 210 Brighton MI 48114-9346 Ph: (810) 522-6080 | 8273 Grand River Rd Ste 210 Brighton MI 48114-9346 Ph: (734) 223-4581 |
| NPI Number | 1275043853 |
|---|---|
| Provider Enumeration Date | 10/09/2017 |
| Last Update Date | 12/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275043853 | NPI | - | NPPES |
| MD.203771 | Other | LA | LOUISIANA STATE BOARD OF MEDICAL EXAMINERS |
| 51983 | Other | AZ | ARIZONA MEDICAL BOARD |
| 4301073973 | Other | MI | STATE OF MICHIGAN BOARD OF MEDICINE |
| 8919590-1205 | Other | UT | STATE OF UTAH BOARD OF MEDICINE |
| ME131286 | Other | FL | FLORIDA DEPARTMENT OF HEALTH |
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