Individual
MR. DANIEL FANTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1333 BREWERY PARK BLVD, DETROIT, MI 48207-4544
(313) 656-0035
Mailing address
32050 DOHANY DR, FARMINGTON HILLS, MI 48336-1820
(313) 683-0637
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6803086603
MI
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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