Individual
NATHANIEL PAUL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18109 MARX ST, DETROIT, MI 48203-5401
(313) 854-9164
Mailing address
18109 MARX ST, DETROIT, MI 48203-5401
(313) 854-9164
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703119292
MI
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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