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Organization
PHYSIQUE MEDICAL WELLNES CLINIC PLLC
Active
Organization
PHYSIQUE MEDICAL WELLNES CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA L ROMAN MSN, FNP-BC (OWNER)
(248) 908-9079
Entity
Organization
Contact information
Practice address
23815 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-7738
(248) 208-9079
(248) 208-9079
Mailing address
23815 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-7738
(248) 208-9079
(248) 208-9079
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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