Individual
ANISSA DUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 W. FOREST, APT. 2, DETROIT, MI 48201
(231) 670-6209
Mailing address
910 W. FOREST, APT. 2, DETROIT, MI 48201
(231) 670-6209
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UL7316818
MEDIMPACT
MI
Enumeration date
09/01/2016
Last updated
09/01/2016
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