Individual
CORINNE N GRATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
43141 WOODWARD AVE, BLOOMFIELD HILLS, MI 48302-5005
(248) 333-0333
Mailing address
53568 CHERRYWOOD DR, SHELBY TOWNSHIP, MI 48315-1348
(616) 638-3824
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004806
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1071654
NCCPA CERTIFICATE
—
01
—
5601004806
LICENSE
MI
Enumeration date
09/25/2006
Last updated
12/11/2023
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