Individual
RALPHAEL GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3527 BISHOP ST, DETROIT, MI 48224-2313
(313) 622-2547
Mailing address
3527 BISHOP ST, DETROIT, MI 48224-2313
(313) 622-2547
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110828
MI
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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