Individual
STACEY WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 W OTIS AVE, HAZEL PARK, MI 48030-3208
(248) 632-8477
Mailing address
149 W OTIS AVE, HAZEL PARK, MI 48030-3208
(248) 632-8477
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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