Individual
IMELDA CUA AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
26757 PATRICIA AVE, WARREN, MI 48091-4137
(586) 757-6379
Mailing address
26757 PATRICIA AVE, WARREN, MI 48091-4137
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004333
MI
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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