| Johanna E Champagne Llc | |
|
1103 S Washington Ave Royal Oak MI 48067-3219 | |
| (248) 518-0018 | |
| Not Available |
| Full Name | Johanna E Champagne Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1103 S Washington Ave, Royal Oak, Michigan |
| Authorized Official Name and Position | Johanna Champagne (OWNER / AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2485180018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johanna E Champagne Llc 1103 S Washington Ave Royal Oak MI 48067-3219 Ph: (248) 518-0018 | Johanna E Champagne Llc 1103 S Washington Ave Royal Oak MI 48067-3219 Ph: (248) 518-0018 |
| NPI Number | 1215383690 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 05/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215383690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401013115 (Michigan) | Primary |
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