Individual
TAVARES CARNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 BRUSH ST APT 323, DETROIT, MI 48201-2655
(248) 631-7489
Mailing address
25614 W 12 MILE RD APT 305, SOUTHFIELD, MI 48034-8034
(248) 631-7489
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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