Individual
MR. GREGORY M MACISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25401 HARPER AVE, SAINT CLAIR SHORES, MI 48081-2240
(586) 466-6912
(586) 466-6961
Mailing address
2082 MALVINA ST, LINCOLN PARK, MI 48146-3458
(313) 381-1681
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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