Individual
DOLORES MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10781 WAYBURN ST, DETROIT, MI 48224-2471
(313) 720-4106
Mailing address
10781 WAYBURN ST, DETROIT, MI 48224-2471
(313) 720-4106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110727
MI
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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