Individual
DIANE STEPHANIE KACZMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
36367 HARPER AVE, CLINTON TWP, MI 48035-2958
(586) 791-6868
(586) 791-5071
Mailing address
36367 HARPER AVE, CLINTON TWP, MI 48035-2958
(586) 791-6868
(586) 791-5071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001308
MI
Other
Enumeration date
05/11/2006
Last updated
09/08/2016
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