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Individual

WILLIAM CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
50430 SCHOOL HOUSE RD, CANTON, MI 48187-5910
(734) 589-7974
Mailing address
50430 SCHOOL HOUSE RD, CANTON, MI 48187-5910
(734) 589-7974

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
282334
MI
Enumeration date
11/05/2019
Last updated
11/05/2019
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