Individual
FERNANDO R WILLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8881 CLOVERLAWN ST, DETROIT, MI 48204-2728
(313) 473-9014
Mailing address
17606 SAN JUAN DR, DETROIT, MI 48221-2698
(313) 473-9014
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
01/07/2025
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