Individual
MISS KAYLA ANN WILSON-GROVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
18248 FLEUR DE LIS, CLINTON TOWNSHIP, MI 48038-1286
(734) 735-1332
Mailing address
18248 FLEUR DE LIS, CLINTON TOWNSHIP, MI 48038-1286
(734) 735-1332
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
59854
MI
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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