Individual
JANEISE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9426 LISA, ROMULUS, MI 48174
(313) 404-3699
Mailing address
9426 LISA ST, ROMULUS, MI 48174-1575
(313) 404-3699
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113224
MI
225700000X
Massage Therapist
7501002446
MI
Other
Enumeration date
04/14/2014
Last updated
10/04/2014
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