Individual
ANGEL PHILLIP ZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7412 COLF RD, CARLETON, MI 48117-9136
(734) 733-8980
Mailing address
7412 COLF RD, CARLETON, MI 48117-9136
(734) 733-8980
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111925
MI
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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