Individual
AFUSAT DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
5840 N CANTON CENTER RD STE 212, CANTON, MI 48187-2614
(734) 844-6533
Mailing address
8950 ARNOLD, REDFORD, MI 48239-1528
(313) 739-3025
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703108850
MI
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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