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Individual

MOSES DAKROUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
30765 ANN ARBOR TRL, WESTLAND, MI 48185-2473
(313) 800-3611
Mailing address
431 SYLVAN ST, DEARBORN, MI 48124-1072
(313) 979-0304

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005731
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D261609609381
MI
Enumeration date
10/08/2018
Last updated
10/08/2018
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