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Individual

PROF. MARY-ANNE ANGELINE POLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
22550 HALL RD, CLINTON TOWNSHIP, MI 48036-1189
(586) 466-7904
Mailing address
39475 LAKESHORE DR, HARRISON TOWNSHIP, MI 48045-1863
(586) 465-3258

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
5201001745
MI
174400000X
Specialist
Primary
5201001745
MI

Other

Enumeration date
02/05/2007
Last updated
05/27/2010
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