Individual
LATRESE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24641 RIDGEDALE ST, OAK PARK, MI 48237-1451
(313) 397-5173
Mailing address
24641 RIDGEDALE ST, OAK PARK, MI 48237-1451
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704270936
MI
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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