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Individual

ELIJAH DOOLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 831-3160
Mailing address
16140 TULLER ST, DETROIT, MI 48221-2925

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122340
MI

Other

Enumeration date
05/06/2020
Last updated
05/06/2020
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