Individual
MATTHEW WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12815 BREST ST, SOUTHGATE, MI 48195-1002
(734) 752-9597
Mailing address
12815 BREST ST, SOUTHGATE, MI 48195-1002
(734) 752-9597
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111952
MI
Other
Enumeration date
02/05/2022
Last updated
02/05/2022
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