Provider Demographics
NPI:1912469974
Name:MICHIGAN EAR INSTITUTE PLLC
Entity Type:Organization
Organization Name:MICHIGAN EAR INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-865-4135
Mailing Address - Street 1:30055 NORTHWESTERN HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3260
Mailing Address - Country:US
Mailing Address - Phone:248-865-4135
Mailing Address - Fax:248-865-6161
Practice Address - Street 1:30055 NORTHWESTERN HWY STE 101
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3260
Practice Address - Country:US
Practice Address - Phone:248-865-4135
Practice Address - Fax:248-865-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty