Individual
ELIZABETH BARRETT BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-6896
Mailing address
1102 MIDLAND BLVD, ROYAL OAK, MI 48073-2889
(248) 515-0576
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005847
MI
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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