Individual
GRACE LEYSON ROSETE-LASALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26001 FORD RD, DEARBORN HEIGHTS, MI 48127
(313) 274-4600
(313) 274-4079
Mailing address
9938 ALLEN POINT DR, ALLEN PARK, MI 48101
(313) 928-4475
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704230094
MI
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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