Individual
DESIREE SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
517 GRATEN ST, BIRMINGHAM, MI 48009-6519
(248) 952-4011
(248) 282-0455
Mailing address
517 GRATEN ST, BIRMINGHAM, MI 48009-6519
(248) 952-4011
(248) 282-0455
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
AS820379695
MI
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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