Individual
AMANDA IZOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9404 ESSEX ST, ROMULUS, MI 48174-1534
(313) 234-3374
Mailing address
9404 ESSEX ST, ROMULUS, MI 48174-1534
(313) 234-3374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704312780
MI
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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