Individual
MR. GEOFFREY THANE D'ALLEMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19401 HUBBARD DR, SUITE 104, DEARBORN, MI 48126-2641
(313) 982-8151
Mailing address
126 AUSTIN AVE, ROYAL OAK, MI 48067-1706
(248) 399-0973
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001396
MI
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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