Individual
LENA OLIVIA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6144 SMITHFIELD DR, TROY, MI 48085-1080
(313) 646-8347
Mailing address
6144 SMITHFIELD DR, TROY, MI 48085-1080
(313) 646-8347
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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