| Tracey Torosian, Ph.d., Pllc | |
|
20816 E 11 Mile Rd Suite 112 Saint Clair Shores MI 48081-1565 | |
| (586) 774-7344 | |
| (586) 774-7345 |
| Full Name | Tracey Torosian, Ph.d., Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 20816 E 11 Mile Rd, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Tracey Torosian (SOLE PROPRIETOR) |
| Authorized Official Contact | 5867747344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracey Torosian, Ph.d., Pllc 20816 E 11 Mile Rd Suite 112 Saint Clair Shores MI 48081-1565 Ph: (586) 774-7344 | Tracey Torosian, Ph.d., Pllc 20816 E 11 Mile Rd Suite 112 Saint Clair Shores MI 48081-1565 Ph: (586) 774-7344 |
| NPI Number | 1700181211 |
|---|---|
| Provider Enumeration Date | 01/13/2011 |
| Last Update Date | 01/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700181211 | NPI | - | NPPES |
| 1962531335 | Other | MI | NPI TYPE 1 |
| 680E046090 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 6301009014 (Michigan) | Primary |
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