Individual
HORACIO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
111 W 7 MILE RD, DETROIT, MI 48203-1968
(313) 368-2600
(313) 369-2477
Mailing address
13901 E JEFFERSON AVE, DETROIT, MI 48215-2720
(313) 821-2591
(313) 822-0950
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
95396184
MI
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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