Individual
LOUELLA CANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18269 APPOLINE ST, DETROIT, MI 48235-1451
(248) 236-5353
(248) 236-5354
Mailing address
18269 APPOLINE ST, DETROIT, MI 48235-1451
(248) 236-5353
(248) 236-5354
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
L2574
MI
Other
Enumeration date
09/27/2013
Last updated
09/08/2016
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