Individual
THERESA MARIE CIROCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2799 W GRAND BLVD RM E235, DETROIT, MI 48202-2608
(313) 916-2417
(313) 916-8416
Mailing address
11919 CHASE BLVD, LIVONIA, MI 48150-5039
(734) 953-2665
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704168297
MI
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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