Individual
GODWIN ILONZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
388 W HAYES AVE, HAZEL PARK, MI 48030-2411
(313) 377-4486
Mailing address
388 W HAYES AVE, HAZEL PARK, MI 48030-2411
(313) 377-4486
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
AS630386442
MI
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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