Individual
SANDRA KAY MASTROGIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1759 MARKESE AVE, LINCOLN PARK, MI 48146-3254
(313) 585-6072
Mailing address
1759 MARKESE AVE, LINCOLN PARK, MI 48146-3254
(313) 585-6072
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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