| Goddard Clinic Pc | |
|
17234 Goddard Rd Allen Park MI 48101-4100 | |
| (313) 386-3960 | |
| (313) 386-0145 |
| Full Name | Goddard Clinic Pc |
|---|---|
| Speciality | General Practice |
| Location | 17234 Goddard Rd, Allen Park, Michigan |
| Authorized Official Name and Position | Kenneth William Debyle (PRESIDENT) |
| Authorized Official Contact | 3133863960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goddard Clinic Pc 17234 Goddard Rd Allen Park MI 48101-4100 Ph: (313) 386-3960 | Goddard Clinic Pc 17234 Goddard Rd Allen Park MI 48101-4100 Ph: (313) 386-3960 |
| NPI Number | 1427266113 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427266113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 5101005616 (Michigan) | Primary |
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