Individual
TANZY CHILDREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2336 HOGAN WAY, CANTON, MI 48188-6301
(313) 414-6406
Mailing address
2336 HOGAN WAY, CANTON, MI 48188-6301
(313) 414-6406
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703112194
MI
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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