Individual
VANESSA BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19691 HASSE ST, DETROIT, MI 48234-2155
(313) 826-1986
Mailing address
19691 HASSE ST, DETROIT, MI 48234-2155
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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