Individual
JUANITA ALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13037 WILSHIRE DR, DETROIT, MI 48213-1975
(313) 310-9487
Mailing address
13037 WILSHIRE DR, DETROIT, MI 48213-1975
(313) 310-9487
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110726
MI
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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