Individual
MRS. MARY CLARISSA R SALVAGGIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
24013 VANCE AVE, HAZEL PARK, MI 48030-1218
(248) 860-1754
Mailing address
24013 VANCE AVE, HAZEL PARK, MI 48030-1218
(248) 860-1754
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4704289245
MI
363L00000X
Nurse Practitioner
Primary
4704289245
MI
Other
Enumeration date
09/12/2022
Last updated
10/06/2022
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