Individual
JULIE WALTERS LIPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
26025 LAHSER RD, 2ND FLOOR, SOUTHFIELD, MI 48033-2606
(248) 703-9408
Mailing address
26025 LAHSER RD, 2ND FLOOR, SOUTHFIELD, MI 48033-2606
(248) 703-9408
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006660
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154760650
—
MI
Enumeration date
06/18/2013
Last updated
05/04/2015
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