| Online Controlled Kravings Weight Loss Pllc | |
|
21701 W 11 Mile Rd Ste 5 Southfield MI 48076-3713 | |
| (248) 429-9556 | |
| Not Available |
| Full Name | Online Controlled Kravings Weight Loss Pllc |
|---|---|
| Speciality | General Practice |
| Location | 21701 W 11 Mile Rd Ste 5, Southfield, Michigan |
| Authorized Official Name and Position | Zakari Tata (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2484299556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Online Controlled Kravings Weight Loss Pllc 21701 W 11 Mile Rd Ste 5 Southfield MI 48076-3713 Ph: (248) 429-9556 | Online Controlled Kravings Weight Loss Pllc 21701 W 11 Mile Rd Ste 5 Southfield MI 48076-3713 Ph: (248) 429-9556 |
| NPI Number | 1043096761 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043096761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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