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Individual

MIA A DECERCHIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
30301 NORTHWESTERN HWY STE 200, FARMINGTON HILLS, MI 48334-3278
(248) 549-4339
Mailing address
1376 PEMBROKE DR, BLOOMFIELD HILLS, MI 48304-2653
(248) 520-8758

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary
262603067927
MI

Other

Enumeration date
11/23/2024
Last updated
11/23/2024
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